Biometric gonioscopy and the effects of age, race, and sex on the anterior chamber angle.

AIM:

To utilise a novel method for making measurements in the anterior chamber in order to compare the anterior chamber angles of people of European, African, and east Asian descent aged 40 years and over.

METHODS:

A cross sectional study on 15 people of each sex from each decade from the 40s to the 70s, from each of three racial groups-black, white, and Chinese Singaporeans. Biometric gonioscopy (BG) utilises a slit lamp mounted reticule to make measurements from the apparent iris insertion to Schwalbe's line through a Goldmann one mirror goniolens. The main outcome measures were BG measurements of the anterior chamber angle as detailed above.

RESULTS:

There was no significant difference in angle measurement between black, white, and Chinese races in this study. However, at younger ages people of Chinese race appeared to have deeper angles than white or black people, whereas the angles of older Chinese were significantly narrower (p = 0.004 for the difference in slope of BG by age between Chinese and both black and white people).

CONCLUSION:

The failure to detect a difference in angle measurements between these groups was surprising, given the much higher prevalence of angle closure among Chinese. It appears that the overall apparent similarity of BG means between Chinese and Western populations may mask very different trends with age. The apparently more rapid decline in angle width measurements with age among Chinese may be due to the higher prevalence of cataract or "creeping angle closure." However, longitudinal inferences from cross sectional data are problematic, and this may represent a cohort phenomenon caused by the increasing prevalence of myopia in the younger Singaporean population.

Age, gender, biometry, refractive error, and the anterior chamber angle among Alaskan Eskimos.

BACKGROUND:

The prevalence of angle-closure glaucoma (ACG) is greater for Eskimos/Inuit than it is for any other ethnic group in the world. Although it has been suggested that this prevalence may be due to a population tendency toward shallower anterior chamber angles, available evidence for other populations such as Chinese with high rates of ACG has not consistently demonstrated such a tendency.

METHODS:

A reticule, slit-lamp, and standard Goldmann one-mirror goniolens were used to make measurements in the anterior chamber (AC) angle according to a previously reported protocol for biometric gonioscopy (BG) (Ophthalmology 1999;106:2161-7). Measurements were made in all four quadrants of one eye among 133 phakic Alaskan Eskimos aged 40 years and older. Automatic refraction, dilated examination of the anterior segment and optic nerve, and A-scan measurements of AC depth, lens thickness, and axial length were also carried out for all subjects.

RESULTS:

Both central and peripheral AC measurements for the Eskimo subjects were significantly lower than those previously reported by us for Chinese, blacks, and whites under the identical protocol. Eskimos also seemed to have somewhat more hyperopia. There were no differences in biometric measurements between men and women in this Eskimo population. Angle measurements by BG seemed to decline more rapidly over life among Eskimos and Chinese than blacks or whites. Although there was a significant apparent decrease in AC depth, increase in lens thickness, and increase in hyperopia with age among Eskimos, all of these trends seemed to reverse in the seventh decade and beyond.

CONCLUSIONS:

Eskimos do seem to have shallower ACs than do other racial groups. Measurements of the AC angle seem to decline more rapidly over life among Eskimos than among blacks or whites, a phenomenon also observed by us among Chinese, another group with high ACG prevalence. This apparent more rapid decline may be due to a cohort effect with higher prevalence of myopia and resulting wider angles among younger Eskimos and Chinese.

Validity of a personal and family history of cataract and cataract surgery in genetic studies.

PURPOSE:

To determine the accuracy of a history of cataract and cataract surgery (self-report and for a sibling), and to determine which demographic, cognitive, and medical factors are predictive of an accurate history.

METHODS:

All participants in the Salisbury Eye Evaluation (SEE) project and their locally resident siblings were questioned about a personal and family history of cataract or cataract surgery. Lens grading at the slit lamp, using standardized photographs and a grading system, was performed for both SEE participants (probands) and their siblings. Cognitive testing and a history of systemic comorbidities were also obtained for all probands.

RESULTS:

Sensitivity of a history of cataract provided on behalf of a sibling was 32%, specificity 98%. The performance was better for a history of cataract surgery: sensitivity 90%, specificity 89%. For self-report of cataract, sensitivity was also low at 55%, with specificity at 77%. Self-report of cataract surgery gave a much better performance: sensitivity 94%, specificity 100%. Different cutoffs in the definition of cataract had little impact. Factors predicting a correct history of cataract included high school or greater education in the proband (odds ratio [OR] = 1.13, 95% confidence interval [CI]1.02-1.25) and younger sibling (but not proband) age (OR = 0.94 for each year of age, 95% CI 0.90-0.99). Gender, race and Mini-Mental Status Examination (MMSE) result were not predictive.

CONCLUSIONS:

Whereas accurate self and family histories for cataract surgery may be obtainable, it is difficult to ascertain cataract status accurately from history alone.

Nuclear cataract shows significant familial aggregation in an older population after adjustment for possible shared environmental factors.

PURPOSE: To quantify the association between siblings in age-related nuclear cataract, after adjusting for known environmental and personal risk factors. METHODS: All participants (probands) in the Salisbury Eye Evaluation (SEE) project and their locally resident siblings underwent digital slit lamp photography and were administered a questionnaire to assess risk factors for cataract including: age, gender, lifetime sun exposure, smoking and diabetes history, and use of alcohol and medications such as estrogens and steroids. In addition, blood pressure, body mass index, and serum antioxidants were measured in all participants. Lens photographs were graded by trained observers masked to the subjects' identity, using the Wilmer Cataract Grading System. The odds ratio for siblings for affectedness with nuclear cataract and the sibling correlation of nuclear cataract grade, after adjusting for covariates, were estimated with generalized estimating equations. RESULTS: Among 307 probands (mean age, 77.6 +/- 4.5 years) and 434 full siblings (mean age, 72.4 +/- 7.4 years), the average sibship size was 2.7 per family. After adjustment for covariates, the probability of development of nuclear cataract was significantly increased (odds ratio [OR] = 2.07, 95% confidence interval [CI], 1.30-3.30) among individuals with a sibling with nuclear cataract (nuclear grade > or = 3.0). The final fitted model indicated a magnitude of heritability for nuclear cataract of 35.6% (95% CI: 21.0%-50.3%) after adjustment for the covariates. CONCLUSIONS: Findings in this study are consistent with a genetic effect for age-related nuclear cataract, a common and clinically significant form of lens opacity.

Cataract surgery and subtype in a defined, older population: the SEECAT Project

AIM:

To describe the distribution of cataract subtypes present before surgery among a defined population of older, bilaterally pseudophakic individuals.

METHODS:

This was a cohort study of bilaterally pseudophakic individuals participating in the Salisbury Eye Evaluation (SEE), and their locally resident siblings. Subjects underwent slit lamp and retroillumination photography and grading using the Wilmer Cataract Grading System. For all individuals determined to be bilaterally pseudophakic, an attempt was made to determine for each eye the type(s) of cataract present before surgery, based on previous SEE photographs (for SEE participants) and/or medical records obtained from the operating ophthalmologist (for both SEE participants and their siblings).

RESULTS:

The mean age of 223 participants providing data in this study was 78.7 (SD 5.2) years, 19.3% of subjects were black and 60.1% female. The most common surgically removed cataract subtype in this population was pure nuclear (43.5%), followed by nuclear combined with posterior subcapsular cataract (PSC) (20.6%), and nuclear combined with cortical (13.9%); less common types were pure cortical (4.9%), pure PSC (4.5%), and PSC combined with cortical (2.7%). Factors such as sex and source of lens data (study photograph versus clinical record) did not significantly affect the distribution of lens opacity types, while PSC was significantly (p = 0.01) more common among younger people and nuclear cataract was significantly (p = 0.001) more common among white compared to black people.

CONCLUSION:

Epidemiological studies have suggested that the different subtypes of cataract are associated with different risk factors. As studies begin to identify new prevention strategies for cataract, it would appear likely that different strategies will be efficacious against different types of cataract. In this setting, it will be helpful to know which cataract types are most frequently associated with surgery. Among this older, majority white population, nuclear cataract showed a clear predominance among individuals having undergone surgery in both eyes. This may be contrasted with both clinic and population based studies of younger people, which have generally found PSC cataract to predominate.

Impact of posterior subcapsular opacification on vision and visual function among subjects undergoing cataract surgery in rural China: Study of Cataract Outcomes and Up-Take of Services (SCOUTS) in the Caring is Hip Project, report 5.

AIM: To study the effect of posterior capsular opacification (PCO) on vision and visual function in patients undergoing cataract surgery in rural China, and to compare this with the effect of refractive error. METHODS: Patients undergoing cataract surgery in at least one eye by local surgeons in a rural setting between 8 August and 31 December 2005 were examined with slit lamp grading of PCO 10-14 months after surgery. Subjects with any PCO associated with best-corrected visual acuity of 6/7.5 or worse, or with grade 2+ or worse PCO without visual decrement, were offered YAG laser capsulotomy. Vision and self-reported visual function were assessed, and various demographic and clinical factors potentially associated with PCO were recorded. RESULTS: Of 313 patients operated on within the study window, 239 (76%) could be contacted by telephone; study examinations were performed on 176 (74%). Examined subjects had a mean (SD) age of 69.4 (10.5) years, 116 (67%) were female, and 149 (86%) had been blind (presenting visual acuity < or = 6/60) in the operated eye before surgery. PCO of grade 1 or above was present in 34 of 204 operated eyes (16.7%). Those with PCO had significantly worse presenting vision (p = 0.007) but not visual function (p>0.3) than those without PCO. Women had a significantly higher prevalence of PCO (20.9%) than did men (8.6%, p<0.05). Of 19 eyes undergoing capsulotomy with best-corrected visual acuity measured the next day, 13 (68%) improved by one or more lines, and seven (37%) improved by two or more lines. Despite a higher uptake of capsulotomy (95%) as opposed to refraction (35%) in this cohort, the yield in terms of eyes with poor presenting visual acuity (< 6/18) that could be improved was higher for refraction (26% = 9/35) than for capsulotomy (9% = 3/35). CONCLUSION: The prevalence of PCO and impact on vision and visual function in this cohort was modest 1 year after surgery. However, PCO prevalence increases with time. Follow-up of this cohort is underway to determine the effectiveness of this early intervention in identifying and treating subjects who will eventually experience clinically significant PCO.

Pupil constriction can alter the accuracy of dark room provocative test.

BACKGROUND: Primary angle-closure glaucoma (PACG) is a major cause of visual morbidity in East Asia. Dark-room provocative test (DRPT) has been used to determine which narrow angles have the risk to develop angle closure. However, the accuracy of DRPT might be altered because that after emerging from the dark room, the configuration of the angle is affected by the light of the slit-lamp and the appositionally closed angle reopens. The aim of this study was to examine the pupillary diameter in different light conditions and use it as a parameter to assess the accuracy of dark-room provocative test. METHODS: Patients with suspected primary angle-closure glaucoma undergoing DRPT were recruited. The anterior chamber angle was examined by anterior segment optical coherence tomography under the following conditions: (1) in standard room illumination; (2) after short-term dark-adaptation and (3) after DRPT. Mean values of pupil size and numbers of appositionally closed angle under different conditions were compared. RESULTS: A total of 47 eyes of 47 patients were analyzed. The pupil size after DRPT was smaller than that after short-term dark-adaptation (P < 0.001) and smaller than that in standard room illumination (P = 0.026). The numbers of appositionally closed angles after short-term dark-adaptation were significantly larger than those after DRPT (P < 0.001). There was no significant difference between the numbers of appositionally closed angles in standard room illumination and after DRPT (P = 0.157). CONCLUSIONS: Constriction of pupil size immediately after prolonged dark room provocative test may lead to change in the angle configuration, which may lead to false negative results. We suggest a modified protocol of recording intraocular pressure immediately after DRPT and performing gonioscopy following short-term dark adaptation to improve the accuracy of angle closure assessment.

The value of tests in the diagnosis and management of glaucoma.

PURPOSE:

To assess the noneconomic value of tests used in the diagnosis and management of glaucoma, and explore the contexts and factors that determine such value.

DESIGN:

Perspective.

METHODS:

Selected articles from primary and secondary sources were reviewed and interpreted in the context of the authors' clinical and research experience, influenced by our perspectives on the tasks of reducing the global problem of irreversible blindness caused by glaucoma. The value of any test used in glaucoma is addressed by 3 questions regarding: its contexts, its kind of value, and its implicit or explicit benefits.

RESULTS:

Tonometry, slit-lamp gonioscopy, and optic disc evaluation remain the foundation of clinic-based case finding, whether in areas of more or less abundant resources. In resource-poor areas, there is urgency in identifying patients at risk for severe functional loss of vision; screening strategies have proven ineffective, and efforts are hindered by the inadequate allocation of support. In resource-abundant areas, the wider spectrum of glaucoma is addressed, with emphasis on early detection of structural changes of little functional consequence; these are increasingly the focus of new and expensive technologies whose clinical value has not been established in longitudinal and population-based studies. These contrasting realities in part reflect differences among the value ascribed, often implicitly, to the tests used in glaucoma.

CONCLUSIONS:

The value of any test is determined by 3 aspects: its context of usage; its comparative worth and to whom its benefit accrues; and how we define historically what we are testing. These multiple factors

Hole-type gaseous detectors for medical imaging and HEP experiments

This work presents the results on the development of a high pressure Xe gaseous detector envisaging medical imaging. The detector uses two VUV photosensors operating face-to-face, based on the CsI-MHSP with position discrimination capability. The known effect of the charge gain decrease with the gas pressure is compensated with a light gain using the electroluminescence process. Studies of signal amplitude, energy and position resolution are presented. On the second part, gaseous detectors based on THGEM where studied in order to fulfill the requirements of present and future high energy physics experiments. The work is focused on the application of THGEM in RICH detectors elements: a triple THGEM detector using CsI photocathodes in Ne mixtures was suggested. The ion backflow to the photocathode remains a concern and a limitation; to minimize it, the application of a new hole-structure, THCOBRA, was suggested. Preliminary results foresee good perspectives for the successful application of THCOBRA in ion back-flow suppression. This work contains several methods and measurements of the CsI photocathodes behaviour in radiation gaseous detectors. A long discussion on its issues and possible solutions are presented.

Photoinactivation of viruses by porphyrins

A inativação fotodinâmica tem sido usada com sucesso na inativação de microorganismos. Diversos aspetos da inativação fotodinâmica foram já estudados para diferentes microrganismos, contudo, existe ainda pouca informação disponível no que diz respeito à inativação de bacteriófagos por processos fotodinâmicos. Este trabalho pretendeu elucidar e avaliar vários aspetos da fotoinativação de vírus, em particular de bacteriófagos, incluindo (i) o efeito de diversos parâmetros de luz utilizados na fotoinativação de bacteriófagos; (ii) a eficiência da inativação fotodinâmica de diferentes tipos de bacteriófagos (fagos do tipo DNA e RNA); (iii) o principal mecanismo através do qual a inativação fotodinâmica tem lugar; (iv) o efeito da fotoinativação nas proteínas do bacteriófago; e (v) o possível desenvolvimento de resistência e recuperação da viabilidade após vários tratamentos fotodinâmicos consecutivos. Para avaliar o efeito dos diferentes parâmetros de luz, suspensões fágicas com 107 UFP mL-1 foram irradiadas com diferentes fontes e doses de luz, intensidades luminosas e tempos de irradiação (30,90 e 270 min) na presença de 0,5; 1,0 e 5,0 μM dos derivados porfirínicos catiónicos Tri- Py+-Me-PF e Tetra-Py+-Me. A eficiência da fotoinativação de diferentes fagos do tipo DNA e RNA, foi avaliada através da irradiação da suspensão fágica com luz branca (40 W m-2) durante 270 min na presença de 0,5 e 5,0 μM do derivado porfirínico Tri-Py+-Me-PF, respetivamente para os fagos do tipo RNA e DNA. O mecanismo através do qual a fotoinativação de fagos de DNA (fago do tipo T4) e de RNA (fago Qb) tem lugar foi avaliado por exposição da suspensão fágica à luz branca com uma potência de 40 W m-2, na presença de fotossensibilizador (Tri-Py+-Me-PF e Tetra-Py+-Me) e inibidores, quer do oxigénio singuleto (azida de sódio e L-histidina) quer de radicais livres (Dmanitol e L-cisteína). Os danos nas proteínas do fago do tipo T4, induzidos pelas espécies reativas de oxigénio geradas por 5,0 μM Tri-Py+-Me-PF, foram avaliados pelo método convencional de SDS-PAGE e por espectroscopia de infravermelho. O possível desenvolvimento de resistência e recuperação da viabilidade após a inativação fotodinâmica dos bacteriófagos foi avaliado após dez ciclos consecutivos de tratamento fotodinâmico incompletos (120 min sob irradiação de luz branca a uma potência de 40 W m-2) na presença de 5,0 μM do derivado porfirínico Tri-Py+-Me-PF. Os resultados deste trabalho mostraram que (i) quando uma quantidade de energia (dose de luz) determinada foi aplicada numa suspensão fágica, a partir de uma mesma fonte irradiação, a fotoinactivação do fago foi tanto mais eficiente quanto mais baixa foi a potência luminosa aplicada; (ii) os bacteriófagos foram eficientemente inativados até ao limite de deteção (redução de 6-7 log); (ii) os fagos do tipo RNA foram inativados mais facilmente do que os fagos do tipo DNA (tempos de exposição mais curtos e com concentração de fotossensibilizador dez vezes menor do que a usada para inativar os fagos do tipo DNA); (iii) o mecanismo do tipo II (via produção de oxigénio singuleto) foi o principal mecanismo através do qual a fotoinativação dos bacteriófagos teve lugar; (iv) foi possível detectar danos no perfil proteico após tratamento fotodinâmico e a espectroscopia de infravermelho apresentou-se como uma metodologia promissora de screening para avaliação dos danos induzidos pela inativação fotodinâmica em proteínas; e (v) após dez ciclos consecutivos de tratamento fotodinâmico, o fago do tipo T4 não revelou nenhum tipo de resistência ao tratamento fotodinâmico nem recuperou a sua viabilidade. Como conclusão, a inativação fotodinâmica microbiana é uma tecnologia bastante eficaz para a fotoinativação de bacteriófagos do tipo DNA e RNA sem invólucro, a qual pode ser considerada como uma alternativa ao tratamento convencional com agentes antivíricos, mesmo com intensidades luminosas baixas, sem o risco associado de desenvolvimento de mecanismos de resistência.

Estudos de síntese e transformação de cromonas e 4-quinolonas

Esta dissertação está dividida em duas partes. Na primeira parte reportam-se métodos de síntese de (E)-3-estirilflavonas e (E)/(Z)-2-aril- 4-cloro-3-estiril-2H-cromenos e estudos de ciclização das (E)-3- estirilflavonas em 5-arilbenzo[c]xantonas. Na segunda parte desenvolveram-se novas rotas de síntese de (E)-2-aril-3-estiril-4- quinolonas e posterior transformação em 5-fenil-12- metilbenzo[c]acridonas e 2,4-diarilfuro[3,2-c]quinolinas. Nesta parte estudou-se também a transformação de 2-aril-4-cloro-1,2-dihidroquinolina- 1,3-dicarbaldeídos em (E)/(Z)-2-aril-4-cloro-3-estiril-1,2- di-hidroquinolina-1-carbaldeídos. A síntese de novos derivados de (E)-3-estirilflavonas, abordada na primeira parte desta dissertação, envolveu estudos de otimização da reação de bromação seguida de ciclização de 3-aril-1-(2- hidroxiaril)propano-1,3-dionas/3-aril-3-hidroxi-1-(2-hidroxiaril)prop-2- en-1-onas em 3-bromoflavonas e o desenvolvimento de uma nova rota de síntese de 3-metilflavonas. As 3-metilflavonas foram sujeitas a bromação e seguidamente transformadas em sais de fosfónio antes de serem utilizadas na síntese de (E)-3-estirilflavonas via reação de Wittig. As 3-bromoflavonas foram também usadas na síntese de (E)-3- estirilflavonas via reação de Heck. A síntese de novos derivados de (E)/(Z)-2-aril-4-cloro-3-estiril-2H-cromenos, via reação de Wittig, envolveu a síntese e formilação de flavanonas. A última transformação reportada na primeira parte desta dissertação é a síntese de 5-arilbenzo[c]xantonas por reação de eletrociclização seguida de oxidação de (E)-3-estirilflavonas. Na segunda parte desta dissertação são estudadas duas vias de síntese de 2-aril-1-metil-4-quinolonas. A primeira via de síntese envolve a síntese de N-(2-acetilfenil)benzamidas, sua ciclização em 4-quinolonas seguida de metilação destas. A segunda via envolve a metilação e ciclização de N-(2-acetilfenil)benzamidas obtendo-se, num só passo, as 2-aril-1-metil-4-quinolonas. Posterior iodação das 2-aril-1-metil-4- quinolonas e subsequente reação de Heck das 2-aril-3-iodo-1-metil-4- quinolonas com estirenos comerciais possibilitaram a síntese de (E)-2- aril-3-estiril-1-metil-4-quinolonas. Estudos de eletrociclização seguidos de oxidação das (E)-2-aril-3-estiril-1-metil-4-quinolonas utilizando uma lâmpada de UV de mercúrio de alta pressão possibilitou a síntese de 5- fenil-12-metilbenzo[c]acridonas, enquanto que o aquecimento em refluxo de 1,2,4-triclorobenzeno deu origem a 2,4-diarilfuro[3,2- c]quinolinas. Nesta segunda parte aborda-se também a síntese de 2-aril-4-cloro-1,2- di-hidroquinolina-1,3-dicarbaldeídos, a partir da formilação de 2-aril- 2,3-di-hidro-4-quinolonas e a sua transformação em (E)/(Z)-2-aril-4- cloro-3-estiril-1,2-di-hidroquinolina-1-carbaldeídos por reação de Wittig. Todos os compostos sintetizados foram caracterizados por espectroscopia de ressonância magnética nuclear de protão e carbono 13C, espectros bidimensionais de correlação heteronuclear (HMBC e HSQC) e, nalguns casos espectros de efeito nuclear Overhauser (NOESY). Os novos produtos foram igualmente caracterizados por espectrometria de massa e sempre que possível análise elementar ou espectrometria de massa de alta resolução.

Correntes harmónicas em lâmpadas compactas: sistema de aquisição e processamento de sinal e impacto nas instalações eléctricas

Dissertação para a obtenção do grau de Mestre em Engenharia Electrotécnica Ramo de Automação e Electrónica Industrial

Consumo inteligente de energia elétrica

Trabalho Final de Mestrado para obtenção do grau de Mestre em Engenharia de Redes de Comunicação e Multimédia

Fonte de Iluminação LED – Avaliação dos Efeitos Fotobiológicos no Olho e Pele

Tendo por referência a diretiva 2006/95/CE, o trabalho desenvolvido no contexto da disciplina de Dissertação/Projeto/Estágio do Mestrado de Engenharia de Instrumentação e Metrologia, decorreu nas instalações do IEP (Instituto Electrotécnico Português) e teve como objetivo principal o desenvolvimento de um procedimento de avaliação dos efeitos fotobiológicos no olho e pele provocados por fontes de emissão contínua (LED), doravante designado método alternativo ao de referência. Os dois métodos, alternativo e de referência, utilizam respectivamente um foto-radiómetro multicanal e um espetro-radiómetro. O procedimento desenvolvido (método alternativo) de acordo com a norma EN/IEC62471) consiste na aquisição dos valores de irradiância com recurso a um foto-radiómetro e posterior determinação dos valores da radiância, com os quais se faz a avaliação dos efeitos fotobiológicos, para fontes de luz LED (Light Emitting Diode) ou GLS (General Lighting Service). A consulta detalhada da norma EN/IEC62471 e a pesquisa sobre os conceitos, definições, equipamentos e metodologias relacionadas com o tema em causa, constituiu o primeiro passo deste projecto. Com recurso aos dois equipamentos, uma fonte de luz LED (módulo de 12 lâmpadas LED) é avaliada em relação aos perigos (ou riscos) actínico UV e UV-A, ao perigo da luz azul e ainda o perigo térmico na retina e térmico na pele, permitindo fazer uma análise comparativa dos resultados. O método alternativo revelou-se bastante flexível e eficaz, proporcionando bons resultados em termos da irradiância e radiância dos referidos efeitos fotobiológicos. A comparação destes resultados com os valores limites de exposição mencionados na norma EN/IEC6247 permitiu afirmar que a fonte de luz LED avaliada não representa perigo fotobiológico para a saúde humana e classifica-se no grupo de risco “isento”. Uma vez cumpridos os objectivos, entendeu-se que seria uma mais-valia para o trabalho já realizado, estudar outro caso prático. Sendo assim, fez-se a avaliação da radiação de apenas um dos LED´s que constituíam a fonte usada nos ensaios anteriores, com o espetro-radiómetro (método de referência) e com uma distância de 200 mm entre a fonte e o medidor. Neste caso verificaram-se diferenças significativas nas quantidades obtidas quando comparadas com os valores normativos. Concluiu-se que o efeito fotobiológico da luz azul insere-se no grupo de “isento”, sem perigo para a saúde. Contudo, o efeito térmico da retina apresenta um aumento considerável da quantidade de radiância, embora dentro do grupo de risco “isento”. Esta classificação de grupos de risco. Face aos resultados obtidos, pode confirmar-se que as lâmpadas LED apresentam segurança fotobiológica, atendendo aos baixos valores de irradiância e radiância dos efeitos fotobiológicos estudados. Pode ainda afirmar-se que a utilização do foto-radiómetro em alternativa ao espetro-radiómetro se revela mais eficaz do ponto de vista de metodologia prática. Este trabalho demonstra a robustez desses dois equipamentos de avaliação dos efeitos fotobiológicos, e procura estabelecer uma linha de orientação para a prevenção dos efeitos adversos na pele e olhos de todos os seres humanos sujeitos à radiação ótica artificial. Quanto às incertezas de medições, em relação ao processo de medição com foto-radiómetro, a sua estimação não se realizou, devido a não rastreabilidade entre as medições indicadas pelo fabricante, no certificado de calibração e as medidas realizadas por outras entidades. Contudo, é propõe-se a sua realização em trabalhos futuros dentro desse âmbito. As incertezas dos resultados de medições com espetro-radiómetro foram parcialmente estimadas. Atendendo às potencialidades do sistema de medição, propõe-se como trabalho futuro, a aplicação da norma IEC62478, que faz parte da aplicação da norma EN/IEC62471 na avaliação do efeito da luz azul, com base na determinação da temperatura de cor correlacionada (CCT) de lâmpadas ou sistemas de lâmpadas incluindo luminárias. Os valores de irradiância e radiância adquiridos nos processos de avaliação, tanto com foto-radiómetro como espectro-radiómetro foram gravados em ficheiro Excel para um CD e anexados a este trabalho.

Vaccination-induced functional competence of circulating human tumor-specific CD8 T-cells.

T-cells specific for foreign (e.g., viral) antigens can give rise to strong protective immune responses, whereas self/tumor antigen-specific T-cells are thought to be less powerful. However, synthetic T-cell vaccines composed of Melan-A/MART-1 peptide, CpG and IFA can induce high frequencies of tumor-specific CD8 T-cells in PBMC of melanoma patients. Here we analyzed the functionality of these T-cells directly ex vivo, by multiparameter flow cytometry. The production of multiple cytokines (IFNγ, TNFα, IL-2) and upregulation of LAMP-1 (CD107a) by tumor (Melan-A/MART-1) specific T-cells was comparable to virus (EBV-BMLF1) specific CD8 T-cells. Furthermore, phosphorylation of STAT1, STAT5 and ERK1/2, and expression of CD3 zeta chain were similar in tumor- and virus-specific T-cells, demonstrating functional signaling pathways. Interestingly, high frequencies of functionally competent T-cells were induced irrespective of patient's age or gender. Finally, CD8 T-cell function correlated with disease-free survival. However, this result is preliminary since the study was a Phase I clinical trial. We conclude that human tumor-specific CD8 T-cells can reach functional competence in vivo, encouraging further development and Phase III trials assessing the clinical efficacy of robust vaccination strategies.