20 resultados para Holladay


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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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BACKGROUND: Isolated GH deficiency (IGHD) is familial in 5-30% of patients. The most frequent form (IGHD-IB) has autosomal recessive inheritance, and it is known that it can be caused by mutations in the GHRH receptor (GHRHR) gene or in the GH gene. However, most forms of IGHD-IB have an unknown genetic cause. In normal subjects, muscarinic cholinergic stimulation causes an increase in pituitary GH release, whereas its blockade has the opposite effect, suggesting that a muscarinic acetylcholine receptor (mAchR) is involved in stimulating GH secretion. Five types of mAchR (M(1)-M(5)) exist. A transgenic mouse in which the function of the M(3) receptor was selectively ablated in the central nervous system has isolated GH deficiency similar to animals with defective GHRH or GHRHR gene. OBJECTIVE: We hypothesized that mAchR mutations may cause a subset of familial IGHD. PATIENTS/METHODS: After confirming the expression of M(1)-M(5) receptor mRNA in human hypothalamus, we analyzed the index cases of 39 families with IGHD-IB for mutations in the genes encoding for the five receptors. Coding sequences for each of the five mAchRs were subjected to direct sequencing. RESULTS: In one family, an affected member was homozygous for a M(3) change in codon 65 that replaces valine with isoleucine (V65I). The V65I receptor was expressed in CHO cells where it had normal ability to transmit methacholine signaling. CONCLUSION: mAchR mutations are absent or rare (less than 2.6%) in familial IGHD type IB.

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A presente pesquisa busca avaliar exegeticamente o texto que se encontra na Bíblia, especificamente no livro de Números capítulos 22-24 que relata sobre um personagem conhecido como Balaão. A pesquisa tem também como objeto o estudo sobre o panteão de divindades relatado no mesmo texto, assim como também o estudo dos textos descobertos em Deir Alla, na Jordânia, que apresentam um personagem designado como Balaão, possivelmente o mesmo personagem de Nm 22-24. A motivação que levou ao desenvolvimento dessa pesquisa foi o fato de se ter deparado com os conceitos dos diversos nomes divinos exibidos no texto, além da questão do profetismo fora de Israel, assim como as possibilidades hermenêuticas que se abrem para a leitura desse texto bíblico. O conceito geral sempre foi o de que Israel era a única nação onde existiam “verdadeiros” profetas e uma adoração a um único Deus, o “monoteísmo”. O que despertou interesse foi perceber, especialmente por meio da leitura dos livros bíblicos, que o profetismo não se restringiu somente a Israel. Ele antecede à formação do antigo Israel e já existia no âmbito das terras do antigo Oriente Médio, e que Israel ainda demorou muito tempo para ser monoteísta. Quem é esse Balaão, filho de Beor? Estudaremos sobre sua pessoa e sua missão. Examinaremos os textos de Deir Alla sobre Balaão e sua natureza de personagem mediador entre o divino e o humano. Esse personagem é apresentado como um grande profeta e que era famoso como intérprete de presságios divinos. Analisaremos a importante questão sobre o panteão de deuses que são apresentados na narrativa de Balaão nomeados como: El, Elyon Elohim e Shaddai, além de Yahweh. Entendemos, a princípio, que o texto possui uma conexão com a sociedade na qual foi criado e usando da metodologia exegética, faremos uma análise da narrativa em questão, buscando compreender o sentido do texto, dentro de seu cenário histórico e social. Cenário este, que nos apresentou esse profeta, não israelita, que profere bênçãos dos deuses sobre Israel e que, além disso, pronuncia maldições sobre os inimigos desse mesmo Israel. Percebemos que, parte do texto pesquisado é apresentado sob a ótica de Israel sobre as outras nações. A pesquisa defende, portanto, que o texto de Nm 22-24, além de nos apresentar um profeta fora de Israel igual aos profetas da Bíblia, defende que, o panteão de divindades também era adorado por Israel e que tais nomes são epítetos de uma mesma divindade, no caso YHWH. Defende, também, um delineamento de um projeto de domínio político e militar de Israel sobre as nações circunvizinhas.

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Purpose. To evaluate theoretically in normal eyes the influence on IOL power (PIOL) calculation of the use of a keratometric index (nk) and to analyze and validate preliminarily the use of an adjusted keratometric index (nkadj) in the IOL power calculation (PIOLadj). Methods. A model of variable keratometric index (nkadj) for corneal power calculation (Pc) was used for IOL power calculation (named PIOLadj). Theoretical differences ($PIOL) between the new proposed formula (PIOLadj) and which is obtained through Gaussian optics (PIOL Gauss) were determined using Gullstrand and Le Grand eye models. The proposed new formula for IOL power calculation (PIOLadj) was prevalidated clinically in 81 eyes of 81 candidates for corneal refractive surgery and compared with Haigis, HofferQ, Holladay, and SRK/T formulas. Results. A theoretical PIOL underestimation greater than 0.5 diopters was present in most of the cases when nk = 1.3375 was used. If nkadj was used for Pc calculation, a maximal calculated error in $PIOL of T0.5 diopters at corneal vertex in most cases was observed independently from the eye model, r1c, and the desired postoperative refraction. The use of nkadj in IOL power calculation (PIOLadj) could be valid with effective lens position optimization nondependent of the corneal power. Conclusions. The use of a single value of nk for Pc calculation can lead to significant errors in PIOL calculation that may explain some IOL power overestimations with conventional formulas. These inaccuracies can be minimized by using the new PIOLadj based on the algorithm of nkadj.

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AIM: To evaluate the prediction error in intraocular lens (IOL) power calculation for a rotationally asymmetric refractive multifocal IOL and the impact on this error of the optimization of the keratometric estimation of the corneal power and the prediction of the effective lens position (ELP). METHODS: Retrospective study including a total of 25 eyes of 13 patients (age, 50 to 83y) with previous cataract surgery with implantation of the Lentis Mplus LS-312 IOL (Oculentis GmbH, Germany). In all cases, an adjusted IOL power (PIOLadj) was calculated based on Gaussian optics using a variable keratometric index value (nkadj) for the estimation of the corneal power (Pkadj) and on a new value for ELP (ELPadj) obtained by multiple regression analysis. This PIOLadj was compared with the IOL power implanted (PIOLReal) and the value proposed by three conventional formulas (Haigis, Hoffer Q and Holladay). RESULTS: PIOLReal was not significantly different than PIOLadj and Holladay IOL power (P>0.05). In the Bland and Altman analysis, PIOLadj showed lower mean difference (-0.07 D) and limits of agreement (of 1.47 and -1.61 D) when compared to PIOLReal than the IOL power value obtained with the Holladay formula. Furthermore, ELPadj was significantly lower than ELP calculated with other conventional formulas (P<0.01) and was found to be dependent on axial length, anterior chamber depth and Pkadj. CONCLUSION: Refractive outcomes after cataract surgery with implantation of the multifocal IOL Lentis Mplus LS-312 can be optimized by minimizing the keratometric error and by estimating ELP using a mathematical expression dependent on anatomical factors.

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Purpose: To evaluate the predictability of the refractive correction achieved with a positional accommodating intraocular lenses (IOL) and to develop a potential optimization of it by minimizing the error associated with the keratometric estimation of the corneal power and by developing a predictive formula for the effective lens position (ELP). Materials and Methods: Clinical data from 25 eyes of 14 patients (age range, 52–77 years) and undergoing cataract surgery with implantation of the accommodating IOL Crystalens HD (Bausch and Lomb) were retrospectively reviewed. In all cases, the calculation of an adjusted IOL power (PIOLadj) based on Gaussian optics considering the residual refractive error was done using a variable keratometric index value (nkadj) for corneal power estimation with and without using an estimation algorithm for ELP obtained by multiple regression analysis (ELPadj). PIOLadj was compared to the real IOL power implanted (PIOLReal, calculated with the SRK-T formula) and also to the values estimated by the Haigis, HofferQ, and Holladay I formulas. Results: No statistically significant differences were found between PIOLReal and PIOLadj when ELPadj was used (P = 0.10), with a range of agreement between calculations of 1.23 D. In contrast, PIOLReal was significantly higher when compared to PIOLadj without using ELPadj and also compared to the values estimated by the other formulas. Conclusions: Predictable refractive outcomes can be obtained with the accommodating IOL Crystalens HD using a variable keratometric index for corneal power estimation and by estimating ELP with an algorithm dependent on anatomical factors and age.

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Mode of access: Internet.

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"Critical essay on authorities": p. [321]-333.

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"New series" vol. II, no. 12.

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"Based on a smaller volume issued by the Johns Hopkins press in 1900 under the title "The diplomatic relations of the United States and Spanish America'."--Pref.