Dexamethasone intravitreal implant(Ozurdex) in diabetic macular edema: real-world data versus clinical trials outcomes

AIM: To investigate the safety and efficacy of intravitreal dexamethasone implants(Ozurdex?/DEX) in patients with diabetic macular edema(DME) either na?ve or nonna?ve to anti-VEGF therapies who switched to DEX implant independent of response to anti-vascular endothelial growth factors(anti-VEGFs).METHODS: This was an audit retrospective review of medical records of patients with DME who switched to the DEX intravitreal implant. Patients were divided into 2 groups: patients na?ve to antiangiogenic therapy and patients who were previously treated with anti-VEGFs. Data regarding demographics, changes in mean best-corrected visual acuity(BCVA), central macular thickness(CMT), and intraocular pressure(IOP) was collected over 6 mo. The demographic data mean changes in BCVA, CMT, and IOP were compared. Six-month follow-up data of 47 patients(57 eyes), who either switched to DEX implant irrespective of response to previous treatments or were treatment na?ve before receiving DEX implant, was collected.RESULTS: Improvement in mean BCVA was observed from 1-4 mo after injection with a decreased effect at month 6 as expected, with better outcomes in na?ve compared to non-na?ve patients. A statistically relevant decrease in mean CMT was observed during the follow-up period. An increase in mean IOP was observed in the first 2 mo after DEX therapy. The mean number of injections of the overall population during the 6 mo was 1.3. A subgroup analysis showed no relevant difference between phakic versus pseudophakic patients relative to measured outcomes. There was no cataract progression during the follow-up period and no adverse events reported.CONCLUSION: This real-life setting study shows that intravitreal DEX implant is effective and safe. The timings of greater therapeutic impact are concordant with previous studies and suggest that earlier treatment with corticosteroids may have an additional benefit in na?ve patients.

Dynamic Balance in Children With Trisomy 21:A Pilot Study

At age 5,children with trisomy 21 have roughly 2 years of delayed motor development.We aimed to verify if children with trisomy 21(AD)(N=6,7.67±1.51 years)had a similar performance to children with a typical development(TD)(N=37,5.19±0.40 years old),in a playful motor action(to spin on herself until she cannot get more).On average,ADs gave less laps,for less time,spending more time per rotation,but without significant difference.Of the AD,one-third fell and rose to continue to spin;one-third stopped and resumed spinning(with intervals of 2.05±0.86s).Three ADs performed the action counterclockwise and the other three in clockwise direction.The results support the hypothesis that AD can perform the activity of spinning,with DT(significantly)younger,allowing to AD momentary pauses and conditions for their physical security.

Carbon Footprint of Tourism Sector in Portugal-Calculator Development

A carbon footprint(CF)calculator was developed to apply to a Portuguese touristic accommodation to contribute to a sustainable touristic activity.Although some calculators are available online,they are related to the country reality or use outdated emission factors.A calculator based on national emission factors is important.The calculator was developed in Microsoft Excel(version 365)and is based on the CO2e emissions resulting from electricity,water,fuels and food use,laundry and waste production.The calculator development involved:study the accommodation emission sources,selection the environmental indicators,determination of the emission factors and development of the CF formulas.Total CF calculation was made considering the partial CF per component,a monthly and annual comparison of each indicator’s emissions contribution using graphs.The emissions amount per overnight stay,per room,per area,were also assessed and these values were transformed into global hectare(gha).Avoided emissions calculation gives the information about the efforts in CF reduction,and two indicators were considered:electricity production from renewable energy sources and the amount of separated waste for recycling.It was considered reforestation measures to achieve carbon neutrality.This calculator incorporates four components not often used:water,laundry,waste,food,and avoided emissions.