IntrodTrabCient

Metodologia
Científica
INTRODUçÃO NO TRABALHO CIENTÍFICO
Partes do Enredo
1.Apresentação
2.Complicação
3.Clímax
4.Desfecho
Partes do Enredo
1.Apresentação
2.Complicação
3.Clímax
4.Desfecho
DESCRIÇÃO
INTRODUÇÃO
• 1a parte de uma história
• Antecipa o conflito e o desfecho
• cada porquinho produz um tipo de casa
que podem ser de 3 tipos.
• não se sabe qual delas é mais resistente
• Testamos com um lobo
• Este artigo apresenta o resultado
FUNÇÕES
1.Despertar interesse
2.Preparar para entender o trabalho
3 “C”s.
• Curta
• Clara
• Cativante
The Three Faces of President Obama
MARCH 15, 2014
Thomas L. Friedman
BARACK OBAMA is surely the first president to be
accused of acting in foreign policy like Pollyanna,
John Wayne and Henry Kissinger in the same
month.
Curta-Clara-Cativante
Steve Jobs' 2005 Stanford commencement
speech: "You've got to find what you love."
I am honored to be with you today at your
commencement from one of the finest universities in
the world. I never graduated from college. Truth be
told, this is the closest I've ever gotten to a college
graduation. Today I want to tell you three stories from
my life. That's it. No big deal. Just three stories.
Curta-Clara-Cativante
‘Esquemas ardilosos’, editorial do Estadão
A polêmica decisão do presidente do Senado, Renan Calheiros, de
transferir para a Comissão de Constituição e Justiça (CCJ) da Casa
a responsabilidade de decidir sobre a ampliação das investigações
da Comissão Parlamentar de Inquérito (CPI) da Petrobrás proposta
pelo PT, é uma manobra claramente procrastinatória destinada, com
o incentivo do Palácio do Planalto, a diluir o impacto do escândalo
da Refinaria de Pasadena, que, graças às trapalhadas de Dilma
Rousseff, acabou criando riscos para o projeto petista de
perpetuação no poder. Trata-se de mais uma chicana política dentre
as muitas do amplo repertório de que o notório presidente do
Senado se vale para levar vantagem em barganhas com o
Executivo.
Curta-Clara-Cativante
“Se hoje é o dia das crianças, ontem eu disse que
criança… o dia da criança é dia da mãe, do pai e das
professoras, mas também é o dia dos animais, sempre
que você olha uma criança, há sempre uma figura oculta,
que é um cachorro atrás.”
O Tamanho depende
da revista…
LEVENTE A. TOTH, MD,*† MICHAEL STEVENSON, BSC, MSC,†
USHA CHAKRAVARTHY, MD, FRCS, PHD*†
Purpose: To assess the effect of anti-vascular endothelial growth factor treatment on
visual acuity outcome in patients with neovascular age-related macular degeneration
presenting with very low vision.
Methods: Retrospective analysis of electronic patient care record of 420 eyes treated with
ranibizumab between March 2010 and June 2013. The authors classified the extracted sample
into 3 categories based on the initial best-corrected visual acuity (BCVA) as measured on the
Early Treatment Diabetic Retinopathy Study charts: 0 to 35 letters, 36 to 69 letters, and $70
letters. Best BCVA achieved in Year 1, and average BCVA over 36 months was computed. The
neovascular lesion type, area of lesion, the presence or absence of hemorrhage, retinal pigment
epithelium tear, and atrophy were systematically graded as was extent of fibrosis on a categorical
scale of 0 to 4. Regression analysis was performed with the best BCVA achieved in Year 1 as the
outcome variable and initial BCVA, person, and lesion characteristics as explanatory variables.
Results: The mean change in BCVA from the initial visit to the best-attained BCVA during
Year 1 was highly statistically significant with an improvement of 9.95 letters. The improvement
from initial BCVA to average BCVA over 36 months was 4.01 letters. Regression analysis
identified atrophy and fibrosis as predictors of best BCVA, with the model having an r2 of 0.71.
Conclusion: Our study supports the use of anti-vascular endothelial growth factor
agents even in eyes with low visual acuity particularly when fibrosis and atrophy are absent
and suggests algorithms to predict outcome for combinations of visual acuity and lesion
characteristics across the full visual acuity range.
LEVENTE A. TOTH,
STEVENSON, BSC, MSC,†
RETINAMD,*†
0:1–7,MICHAEL
2015
USHA CHAKRAVARTHY, MD, FRCS, PHD*†
ANTI-VASCULAR ENDOTHELIAL
GROWTH FACTOR THERAPY FOR
NEOVASCULAR AGE-RELATED MACULAR
DEGENERATION
Outcomes in Eyes With Poor Initial Vision
Purpose: To assess the effect of anti-vascular endothelial growth factor treatment on
visual acuity outcome in patients with neovascular age-related macular degeneration
he current presenting
standardwith
ofvery
care
growth factor or inhibit its binding to its cognate receptor
low for
vision.neovascular
Methods: Retrospective
analysis
of electronic
record
of 420
treated with
age-related macular
degeneration
(nAMD)
is patient
arecare
now
used
to eyes
ameliorate
the unwanted effects of
ranibizumab
between
March
2010
and
June
2013.
The
authors
classified
the
extracted
sample
anti-vascular endothelial growth factor therapy
VEGF in the environment of the Bruch/retinal pigment
1–5 into 3 categories based on the initial best-corrected visual acuity (BCVA) as measured on the
(anti-VEGF). Early
epithelium (RPE)/photoreceptor interfaces of the eye.
Biologicals
that either neutralize this
Treatment Diabetic Retinopathy Study charts: 0 to 35 letters, 36 to 69 letters, and $70
Notably,
exudative
manifestations
and the unconletters. Best BCVA achieved in Year 1, and average BCVA
over 36 the
months
was computed.
The
of the
neovascular
From the *Ophthalmology
Directorate,
BelfasttheHealth
neovascular Service
lesion type,
area of lesion,
presence or trolled
absenceexpansion
of hemorrhage,
retinal
pigment complexes that form
and Social Care Trust,
Belfast,
United
Kingdom;
and
†Centre
for
epithelium tear, and atrophy were systematically graded in
as was
extentare
of fibrosis
on a categorical
nAMD
curtailed
by the administration of antiExperimental Medicine,
scaleSchool
of 0 to of
4. Medicine,
RegressionDentistry
analysis and
wasBiomedperformed with the best BCVA achieved in Year 1 as the
VEGFs into the eye. The pivotal licensing trials and
ical Sciences, Queen’s
University
Belfast,
United
Kingdom.
outcome
variable
and Belfast,
initial BCVA,
person,
and lesion characteristics as explanatory variables.
studies have
shown
improvements in vision
L. A. Toth: Conference
attendance,
grants
from from
Bayer.the initialsubsequent
Results:
The meantravel
change
in BCVA
visit to the best-attained
BCVA
during
U. Chakravarthy: Grants to employing institution from Novartis
in patients
treated
manner.
Year 1 was highly statistically significant with an improvement
of 9.95
letters. in
Thethis
improvement
and Bayer. Attendance at advisory boards, Bayer, Roche, Genentech
from M.
initial
BCVA tohas
average
BCVA over 36 months was
4.01clinical
letters. trials
Regression
analysis exclude patients when
Most
and studies
and Alimera Sciences.
Stevenson
no financial/conflicting
2
with in
the the
model
having an r study
of 0.71.eye is worse than 23
acuity
designated
interests to disclose.identified atrophy and fibrosis as predictors of best BCVA,
Conclusion:
Our
study
supports
the
use
of
anti-vascular
endothelial
growth
factor
Reprint requests: Usha Chakravarthy, MD, FRCS, PhD, Centre for
Early
Treatment
Diabetic
retinopathy
Study letters, that
agents
even and
in eyes
with low
visual acuity
when fibrosis and atrophy
Experimental Medicine,
Dentistry
Biomedical
Sciences,
Instituteparticularly
of
1–12 are absent
is Snellen of20/320.
for excluding eyes
and suggests
to predictRoad,
outcome
visual acuityThe
andrationale
lesion
Clinical Science, Queen’s
Universityalgorithms
of Belfast, Grosvenor
Bel- for combinations
fast BT12 6BA, United
Kingdom; e-mail:
[email protected]
characteristics
across
the full visual acuity range. with poor vision lies in the fact that they are most likely
RETINA 0:1–7, 2015
T
to have had long-standing disease. The natural history
of nAMD is such that there is a rapid reduction in visual
acuity at the onset of disease. Once an acuity level
worse than 20/200 is reached, the rate of further worsening is usually slower and many eyes will retain levels
of acuity between 20/200 and 20/400.13–16 Furthermore, in eyes with low levels of visual acuity, the likelihood of improvement is small, as the chances of having
permanent structural damage to key cells such as the
photoreceptors and RPE are high. Clinical trials and
studies also exclude patients with good visual acuity
(.73 letters). The rationale for this type of exclusion
is that the commonly used metric of an improvement of
$15 letters is unlikely to be achieved, as in this age
group of older adults, medial opacity and the degenerative macular changes are likely to limit the maximum
achievable vision to less than 20/20 Snellen (83 letters).
Therefore, the outcome metric of proportions improving
by 15 or more letters would be impossible owing to
ceiling effects. These concepts have driven the design
and inclusion criteria of the clinical trials in nAMD, and
the pivotal licensing trials for the newer generation of
anti-VEGF therapies have been no exception.10,11,17
To date, the potential beneficial effect of using antiVEGF agents in patients who present with very low
levels of visual acuity has not been systematically
studied. There is a strong rationale for estimating this
benefit, as anti-VEGF agents, unlike previous treatments,
have been shown to result in average improvement in
vision, and furthermore, approximately one third of
treated eyes will show considerable increases of acuity.18
Therefore, it could be argued that even patients with very
low levels of measurable acuity may experience benefits.
However, public healthcare systems tend to act to limit
the use of expensive technologies to populations with
characteristics similar to that enrolled in the clinical trials. In the United Kingdom, the National Institute of
Clinical Excellence (NICE) has set the criteria for selection of patients for treatment based on the licensing trials
and has issued guidance that states that eyes with nAMD
with no prospect of visual improvement should not be
treated.19 Despite this guidance, in clinical practice, patients may be offered treatment even when acuity is
extremely low, if the affected eye is the better-seeing
eye, or if the clinician believes that the majority of the
visual loss is related to the presence of hemorrhage or
exudation without structural damage such as fibrosis and
or atrophy, which are irreversible. Anecdotally, patients
have been found to exhibit quantifiable improvements
even when presenting visual acuity has been extremely
low, but this has not been systemically studied. Hence,
this study aimed to assess and predict the probability of
improvements in visual acuity in patients with nAMD
with very poor initial visual acuity in the treated eye.
3 years, and 47% at 4 years in silicone oil group, and 100% at
6 months and 1 year, and 76% at 2, 3, and 4 years in the control
group (P = 0.03). Complications were similar in the 2 groups
(P = 0.663). The duration of postoperative topical steroid use was
significantly longer in the silicone oil group (P = 0.0003). Silicone
oil was identified as a risk factor for surgical failure by the Cox
hazard model (risk ratio = 3.43; P = 0.04).
METHODS
This was a retrospective comparative study, with a
concurrent comparison group. The study and data accumulation were carried out with approval from the Institutional Review Board, informed consent was obtained from
the patients before surgery, and the study was in
Conclusions: The AGV can control the IOP in the majority of eyes
accordance with Health Insurance Portability and Accountafter pars plana vitrectomy and silicone oil injection. However, the
ability Act (HIPAA) regulations. We reviewed the records
presence of silicone oil is
associatedSTUDY
with increased risk of surgical
ORIGINAL
failure in eyes treated with the AGV.
of consecutive patients who underwent AGV implantation
for glaucoma associated with pars plana vitrectomy and
RIGINAL KeyTUDY
Words: glaucoma drainage implant, silicone oil, intraocular
silicone oil injection for complex retinal disease during
pressure,Glaucoma
refractory glaucoma
Ahmed
Valve Surgical Outcomes in Eyes the period from 1998 to 2005. All implantations were
With
and Without
Silicone Oil Endotamponade
performed for increased IOP that was not responsive to
(J Glaucoma
2009;18:325–330)
maximum tolerated medical therapy and for eyes considKyoko Ishida, MD,*w Iqbal Ike K. Ahmed, MD,zy and Peter A. Netland, MD, PhD*
ered by the retina consultant to be poor candidates for
silicone oil removal owing to risk of redetachment. Eyes
hen silicone oil tamponade was introduced as an
treated with cyclophotocoagulation and the second eyes of
improvements in silicone oil preparations have been
adjunct
toglaucoma
parsvalve
plana
pupillary
blockofwas
Purpose: To compare the results
of Ahmed
(AGV)vitrectomy,
associated with
reduced incidence
secondary IOP
study patients were excluded. A total of 47 eyes (47
8
implantation in eyes containing silicone oil to those without
a common cause of elevated elevation.
intraocular
pressure (IOP).1
silicone oil.
Although eyes with elevated IOP after pars plana
patients) with silicone oil consecutively treated with AGV
peripheral
iridectomy
became
standard
proce-often can be
vitrectomy
and a
silicone
oil endotamponade
Methods: ThisInferior
was a multicenter,
retrospective, comparative
study
implantation were identified. All patients had pars plana
medically,
some require surgical intervenK. Ahmed,
and
Peter
A.
Netland,
MD,
PhD*
of 94 eyes in 94MD,
patients zy
with mean
follow-up
of 2 years,
comparing
2controlled
dure
with
silicone
oil
and
3,6,8,9this cause of secondary
surgical outcomes
in eyes
with silicone
oil (N =
47) injection,
to matched
tion.
Glaucoma drainage device implantation has been
vitrectomy and silicone oil injection for the management of
patients without
silicone oil (N
= 47). is
Success
was rare.
defined as
described as
a usefulwith
treatment
option for these refractory
elevated
IOP
now
However,
even
iridectomy,
intraocular pressure (IOP) of Z6 and r21 mm Hg and 20%
glaucomas, although the statistical power of these studies
complicated retinal detachment. Cases were matched to
reduction of IOP
from reported
preoperative level,incidence
with or without glaucoma
3,6,8
the
of
IOP
silicone
oil
haselevation
been low owingafter
to limited
number of cases.
In this
medicines, and without further glaucoma surgery or loss of light
concurrent controls (not treated previously with silicone
we investigated the 3–8
clinical outcome of Ahmed
perception.
injection ranges from 5.9% study,
to 56%
eyes.
Recent
glaucoma
valveof
(AGV)
implantation
in eyes treated oil)
with by age, sex, and ethnicity.
Results: The mean
IOP and number of medications
at the last oil
pars preparations
plana vitrectomy and silicone
oil endotamponade,
and
improvements
in
silicone
have
been
follow-up were comparable between the 2 groups (P = 0.26 and
compared the results to eyes that had not been treated with
The implant used was the AGV (New World Medical
alve (AGV)
P = 0.12). Theassociated
cumulative probability
of success
by life-table incidence
with
reduced
silicone oil. of secondary IOP
analysis was 85% at 6 months,880% at 1 year, 70% at 2 and
Inc, Rancho Cucamonga, CA), model S2 or FP7.
ose without
elevation.
3 years, and 47%
at 4 years for
in silicone
oil group, and
100% at
Received
publication
February
12, 2008; accepted June 9, 2008.
Implantation of the AGV was performed as described
6 months and 1 year, and 76% at 2, 3, and 4 years in the control
From
the *Department
of
Hamilton
Eye
METHODS
Although
eyes
with
elevated IOP
after
parsInstitute,
plana
group (P = 0.03).
Complications
were similar
in the
2 Ophthalmology,
groups
8,10
previously.
In eyes containing silicone oil, viscoelastic
This wasCenter,
a retrospective
comparative
study, with
a
(P = 0.663). The duration
of postoperative
steroid useHealth
was
University
of topical
Tennessee
Science
Memphis,
TN;
vitrectomy
and
silicone
oil
endotamponade
often
can
be
rative study
significantly longer in the silicone oil group (P = 0.0003). Silicone
concurrent comparison group. The study and data accuwDepartment
of Ophthalmology,
Gifu University
Graduate School
material was used intraoperatively in the anterior chamber
oil was identified
as a risk factor formedically,
surgical failure by the
Cox
mulation
were carried
out with approval
from the Institucontrolled
some
require
surgical
interven, comparing
hazard model (risk ratio
=Medicine,
3.43; P = 0.04). Gifu, Japan; zDepartment
of3,6,8,9
of
Ophthalmology,
tional Review Board, informed consent was obtained from
during tube placement to prevent flow of silicone oil into
to matched
tion.
Glaucoma
drainage
device
implantation
has
been
the Canada;
patients
before
and the
study
University
Toronto,
and surgery,
yDepartment
of was in
Conclusions: The
AGV
can control theof
IOP Toronto,
in the majority of
eyes
the tube while the patient was in the supine position for the
accordance
Health
Insurance
Portability and Accountvitrectomy
and silicone
injection.
However,
the
definedafteraspars planadescribed
Ophthalmology,
University
of Utah,
Saltwith
Lake
City,
UT.
as aoil useful
treatment
option
for
these
refractory
ability Act (HIPAA) regulations. We reviewed the records
presence of silicone oil is associated with increased risk of surgical
procedure. The AGV implant was placed in one of the
The
authors
have
no proprietary
interest
inpower
thepatients
material
presented
g and 20%
failure in eyes treated
with the AGV.
of consecutive
underwent
AGVinimplantation
glaucomas,
although
the statistical
ofwhothese
studies
for glaucoma associated with
pars plana vitrectomy inferior
and
quadrants (inferotemporal or inferonasal) in all
this
manuscript.
ut glaucoma
3,6,8
Key Words: glaucoma
drainage low
implant,owing
silicone oil,to
intraocular
has
been
limited
number
of
cases.
In
this
silicone
oil
injection
for
complex
retinal
disease
during
Reprints:
pressure, refractory
glaucoma Peter A. Netland, MD, PhD, Department of Ophthalmology,
cases to minimize loss of silicone oil through the tube or
oss of light
the period from 1998 to 2005. All implantations were
study,
we
investigated
the
clinical
outcome
of
Ahmed
Hamilton
Eye
Institute,
University
of
Tennessee
Health
Science
performed for increased IOP that was not responsive
to
(J Glaucoma 2009;18:325–330)
tube
blockage. In control eyes, the AGV was placed in one
maximum
tolerated
medical
therapy
for eyes considCenter, 930
Madison
Suite 100,
TN and
38163
glaucoma
valve
(AGV)Avenue,
implantation
in Memphis,
eyes
treated
with
ered by the retina consultant to be poor candidatesof
for the superior quadrants (superotemporal or superonasal)
[email protected]).
at the last
pars(e-mail:
plana
vitrectomy
and
silicone
endotamponade,
and
siliconeoil
oil removal
owing to risk of redetachment.
Eyes
r
hen silicone
oil
tamponade
was
introduced
as
an
inofall cases.
2009 by Lippincott Williams
& Wilkins
treated with
cyclophotocoagulation and the second eyes
= 0.26 and adjunctCopyright
compared
the results
eyes
to pars plana vitrectomy,
pupillaryto
block
was that had not been treated with
study
patients
were
excluded.
A
total
of
47
eyes
(47
a common cause of elevated intraocular pressure (IOP).1
by life-table
patients) with silicone oil consecutively treated with AGV
silicone
oil.
Inferior peripheral iridectomy became a standard proceimplantation were identified. All patients had pars plana
% at 2 dure
andwith silicone
oil injection,2 !and
this cause of
secondary
J Glaucoma
Volume
18,
Numbervitrectomy
4, April–May
www.glaucomajournal.com | 325
and silicone2009
oil injection for the management of
elevated IOP is now rare. However, even with iridectomy,
O
S
Valve Surgical Outcomes in Eyes
WOil Endotamponade
t Silicone
W
nd 100% at
complicated retinal detachment. Cases were matched to
the reported incidence of IOP elevation after silicone oil
concurrent controls (not treated previously with silicone
the control
3–8
injection ranges from 5.9% to 56% of eyes.
Recent
oil) by age, sex, and ethnicity.
METHODS
e 2 groups
The implant used was the AGV (New World Medical
This 12,was
a
retrospective
comparative
study,
Inc,
Rancho Cucamonga,
CA), with
model a
S2 or FP7.
oid use Received
was for publication February
2008; accepted June 9, 2008.
Implantation
of
the
AGV
was
performed
as described
From the *Department
of Ophthalmology,
Hamilton Eye Institute,
03). Silicone
concurrent
comparison
group.previously.
The study
datasilicone
accu8,10
In eyesand
containing
oil, viscoelastic
University of Tennessee Health Science Center, Memphis, TN;
wDepartmentmulation
of Ophthalmology,
Gifu University
Graduate
Schoolwith
material
was used intraoperatively
in the anterior chamber
by the Cox
were
carried
out
approval
from the Instituof Medicine, Gifu, Japan; zDepartment of Ophthalmology,
University of Toronto, Toronto, Canada; and yDepartment of
during tube placement to prevent flow of silicone oil into
tional Review Board, informed consent was obtained from
INTRODUÇÃO
• 1a parte de uma história/Antecipa o
conflito
• Despertar interesse / Preparar para
entender o trabalho
• Curta / Clara / Cativante
O que faz parte?
• Contexto sobre o assunto
• A necessidade
• O que foi feito para resolver a
necessidade
• O conteúdo do artigo
O que não faz parte
• Respostas
• Resultados
• Conseqüências
Conhecido, desconhecido,
resto
Conhecido, desconhecido e
pergunta
Contexto
(o que se sabe)
O que não se sabe
O que foi feito a respeito
o conteúdo do artigo
over the total follow-up (P " 0.007).
een the different
groups. More Topical
specifically,
patients
in the steroid group
Conclusions:
ketorolac
or fluorometholone
for 1neede
month
the total follow-up
(P " 0.007).
trabeculectomy
outcomes in terms of likelihood of postoperative
onclusions:significantly
Topical ketorolac
fluorometholone
1 month before
surgery
reducedor
need
for additional for
postoperative
IOP-lowering
Financial
The of
author(s)
have no needling.
proprietary
c
culectomy outcomes
in Disclosure(s):
terms of likelihood
postoperative
In orthe
in this
article.
Ophthalmology
2010;117:1324
–1330
© 2010 by
th
cantly reduced
need
for additional
postoperative
IOP-lowering
medication
com
Conhecido, desconhecido e
pergunta
nancial Disclosure(s): The author(s) have no proprietary or commercial intere
s article. Ophthalmology 2010;117:1324 –1330 © 2010 by the American Aca
Trabeculectomy is the treatment of choice to reduce intraocoperative
ular pressure (IOP) and to prevent further visual field deteany bene
1–5
rioration
in
medically
uncontrolled
glaucoma.
However,
Preope
culectomy is the treatment of choice to reduce intraocoperative subconjunctival
one of the main causes of surgical failure is the occurrence
tive or ad
ressure (IOP) and to prevent further visual field deteany benefits on surgical ou
of excessive postoperative 1–5
scarring in the region of the
ure has
on in medically
uncontrolled
glaucoma.
However,
Preoperative
anti-inflam
scleral flap. Many adjunctive antifibrotic therapies to
infiltratio
f the main causes
of surgical
failure is the scarring
occurrence
tive orinvestiadditional eral
approach
counteract
this conjunctival
have been
studi
cessive postoperative
in theantifibrotic
region of agents,
the
ure has been
gated.6 –13 scarring
Two common
mitomycin
C associated
of IOP-lo
l flap. Many
antifibrotic
therapies
to enhance
infiltration
of fibroblasts
an
andadjunctive
5-fluorouracil,
have been
shown to
success
conjuncti
9 –13 investieract this conjunctival
scarring have been
rates after trabeculectomy.
These agentseral
arestudies
associ-have provided
contribut
6 –13
Two common
antifibrotic
agents,
mitomycin
C
ofand
IOP-lowering
medicatio
ated with
complications
such
as thin-walled
avascufailure af
-fluorouracil,
been
shown wound
to enhance
conjunctival inflammation.
larhave
blebs,
hypotony,
leaks,success
blebitis, endophthalmitis,
tioned fin
14 –18
and scleral9 –13
melting.
Further
using anti–
conjuncti
after trabeculectomy.
These
agents
are clinical
associ- trialscontribute
to subconjunctiv
transforming
growth
factor !and
antibodies
post-filtration
lowering
with complications
such as
thin-walled
avascu-to counteract
failure after
surge
ative IOP-lowering medication compared with the other groups.
no proprietary or commercial interest in any materials discussed
330 © 2010 by the American Academy of Ophthalmology.
traocdetewever,
rrence
of the
es to
vesticin C
ccess
ssociasculmitis,
anti–
post-
desconhecido
operative subconjunctival fibrosis could not demonstrate
any benefits on surgical outcome.19,20
Preoperative anti-inflammatory treatment is an alternative or additional approach to counteract fibrosis. Bleb failure has been associated with an increased conjunctival
infiltration of fibroblasts and inflammatory cells.21–23 Several studies have provided evidence that the long-term use
of IOP-lowering medication is associated with subclinical
conjunctival inflammation. This inflammation is assumed to
contribute to subconjunctival scarring and subsequent bleb
failure after filtration surgery.24 –30 Based on the aforementioned findings, it can be presumed that the suppression of
Breusegem
et al ! topical
NSAID
or Steroid befor
conjunctival inflammation caused
by long-term
IOPlowering treatment may help to prevent the excessive scara purse-string
ring that leads to bleb failure after trabeculectomy. Thereand dexamet
fore, a prospective, randomized, ISSN
controlled
clinical
trial
was
0161-6420/10/$–see front matter
at the end of
conducted to test this hypothesis with
regard to clinical
doi:10.1016/j.ophtha.2009.11.038
for 8 weeks.
infiltration of fibroblasts and inflammatory cells.
Several studies have provided evidence that the long-term use
of IOP-lowering medication is associated with subclinical
conjunctival inflammation. This inflammation is assumed to
contribute to subconjunctival scarring and subsequent bleb
24 –30
failure after filtration surgery.
Based on the aforementioned findings, it can be presumed that the suppression of
Breusegem
et al ! topical
NSAID
or St
conjunctival inflammation caused
by long-term
IOPlowering treatment may help to prevent the excessive scarring that leads to bleb failure after trabeculectomy. Therefore, a prospective, randomized, ISSN
controlled
clinical trial
was
0161-6420/10/$–see
front matter
doi:10.1016/j.ophtha.2009.11.038
conducted to test this hypothesis with
regard to clinical
outcomes.
O que foi feito
Patients and Methods
This prospective, randomized, double-blind, placebo-controlled
Design: Prospective, randomized placebo-controlled trial.
Participants:
Sixty-one
patients.
Methods: Between July 2005 and October
2007,
61 consecutive
medically uncontrolled glaucoma patients
Participants:
Sixty-one
patients.
Methods:
Between
July
2005
and
October
2007,
61 61
consecutive
medically
uncontrolled
glaucoma
patients
scheduled for first-time trabeculectomy were randomized
1 of 3
study
topical
medication
groups:
nonsteroidal
Methods: to
Between
July
2005 and
October
2007,
consecutive
medically
uncontrolled
glaucoma
patients
scheduled
for first-time
trabeculectomy
were
randomized
to 1toof1 3ofstudy
topical
medication
groups:
nonsteroidal
scheduled
for
first-time
trabeculectomy
were
randomized
3
study
topical
medication
groups:
nonsteroidal
anti-inflammatory drugs (ketorolac), steroidsanti-inflammatory
(fluorometholone),
or
placebo
(artificial
tears).
Patients
instilled
1
drugs
(ketorolac),
steroids
(fluorometholone),
or or
placebo
(artificial
tears).
Patients
instilled
1 1
anti-inflammatory
drugs
(ketorolac),
steroids
(fluorometholone),
placebo
(artificial
tears).
Patients
instilled
dropdrop
4 times
dailydaily
for 1formonth
before
the
procedure
were
examined
on on
days
and
2,4,2,
at at
weeks
1, 1,
2, 2,
and
4, 4,
drop 4 times daily for 1 month before the procedure
and
were
examined
on
days
1and
and
2,
atexamined
weeks
1,
2,1 and
4 times
1
month
before
the
procedure
and
were
days
1 and
weeks
and
andand
at months
3, 6,3,12,
18, 18,
andand
24 after
trabeculectomy.
at months
6, 12,
24 after
trabeculectomy.
and at months 3, 6, 12, 18, and 24 after trabeculectomy.
Main
Outcome
Measures:
of postoperative
surgical
or or
medical
interventions
(needling,
laser
Main
Outcome
Measures:Incidence
Incidence
of postoperative
surgical
medical
interventions
(needling,
laser
Main Outcome Measures: Incidence of
postoperative
surgical
or
medical
interventions
(needling,
laser
suture
lysis,
needling
revision,
and
intraocular
pressure
[IOP]-lowering
medication).
suture lysis, needling revision, and intraocular pressure [IOP]-lowering medication).
Fifty-four
patients
(54 (54
eyes)
were
entered
for for
analysis.
TheThe
mean
number
of of
preoperative
medicasuture lysis, needling revision, and intraocularResults:
pressure
[IOP]-lowering
medication).
Results:
Fifty-four
patients
eyes)
were
entered
analysis.
mean
number
preoperative
medicationstions
waswas
2.3!0.9.
The
mean
baseline
IOP
was
21.0!6.0
mmHg.
The
mean
postoperative
target
IOP
was
2.3!0.9.
The mean
baseline
IOPnumber
was 21.0!6.0
mmHg. The mean
postoperative target IOP
was
Results: Fifty-four patients (54 eyes) were
entered
for
analysis.
The
mean
of
preoperative
medica16.5!1.8
mmHg.
TheThe
mean
follow-up
waswas
23.6!4.0
months.
TheThe
percentage
of of
patients
requiring
needling
16.5!1.8
mmHg.
mean
follow-up
23.6!4.0
months.
percentage
patients
requiring
needling
tions was 2.3!0.9. The mean baseline IOPwithin
was
mmHg.
mean
postoperative
target
was
the21.0!6.0
firstfirst
yearyear
waswas
41%
in the
placebo
group,
6%6%
in the
NSAID,
andand
5%5%
inIOP
the
steroid
group
(P (P
""
0.006).
within
the
41%
in The
the
placebo
group,
in the
NSAID,
in the
steroid
group
0.006).
percentage
of patients
requiring
IOP-lowering
medication
to reach
thethe
target
IOP
at at
1 year
was
24%
in in
thethe
16.5!1.8 mmHg. The mean follow-up wasThe
23.6!4.0
months.
The
percentage
of
patients
needling
The
percentage
of patients
requiring
IOP-lowering
medication
torequiring
reach
target
IOP
1 year
was
24%
placebo
group,
18%
in the
NSAID
group,
andand
0%0%
in the
steroid
group
(P "
0.054
overall;
P"
0.038
forfor
steroids
placebo
group,
18%
in
the
NSAID
group,
in
the
steroid
group
(P
"
0.054
overall;
P
"
0.038
steroids
within the first year was 41% in the placebovs.
group,
6%
in
the NSAID,
anda significant
5% in the
steroid
group (Pin "
0.006).
others).
TheThe
log-rank
testtest
showed
(P (P
"
0.019)
difference
medication-free
survival
curves
vs.
others).
log-rank
showed
a significant
" 0.019)
difference in
medication-free
survival
curves
The percentage of patients requiring IOP-lowering
medication
to
reach
the
target
IOP
at
1
year
was
24%
insignificantly
the less
between
the
different
groups.
More
specifically,
patients
in
the
steroid
group
needed
significantly
medication
between the different groups. More specifically, patients in the steroid group needed
less
medication
over
the in
total
follow-up
(P group
"
over
the
total
follow-up
(P0.007).
" 0.007).
placebo group, 18% in the NSAID group, and
0%
the
steroid
(P " 0.054 overall; P " 0.038 for steroids
Conclusions:
Topical
ketorolac
or fluorometholone
for for
1 month
before
surgery
was
associated
with
improved
Conclusions:
Topical
ketorolac
or fluorometholone
1 month
before
surgery
was
associated
with
improved
vs. others). The log-rank test showed a significant
(P outcomes
" outcomes
0.019)
difference
in medication-free
survival
curves
trabeculectomy
in terms
of likelihood
of of
postoperative
needling.
In In
thethe
steroid
group,
there
trabeculectomy
in terms
of likelihood
postoperative
needling.
steroid
group,
therewas
wasa a
between the different groups. More specifically,
patients
in the
steroid
group
neededIOP-lowering
significantly
less medication
significantly
reduced
need
for additional
postoperative
medication
compared
with
thethe
other
groups.
significantly
reduced
need
for additional
postoperative
IOP-lowering
medication
compared
with
other
groups.
Financial
Disclosure(s):
TheThe
author(s)
have
no no
proprietary
or commercial
interest
in any
materials
discussed
Financial
Disclosure(s):
author(s)
have
proprietary
or commercial
interest
in any
materials
discussed
over the total follow-up (P " 0.007).
in this
article.
Ophthalmology
2010;117:1324
–1330
© 2010
by by
thethe
American
Academy
of of
Ophthalmology.
in this
article.
Ophthalmology
2010;117:1324
–1330
© 2010
American
Academy
Ophthalmology.
Conclusions: Topical ketorolac or fluorometholone for 1 month before surgery was associated with improved
trabeculectomy outcomes in terms of likelihood of postoperative needling. In the steroid group, there was a
significantly reduced need for additional postoperative
IOP-lowering
compared
with
the
other groups.
Trabeculectomy
is the
ofmedication
choice
to reduce
intraocsubconjunctival
fibrosis
could
notnot
demonstrate
Trabeculectomy
is treatment
the treatment
of choice
to reduce
intraoc- operative
operative
subconjunctival
fibrosis
could
demonstrate
19,20
19,20
(IOP)
to
further
visual
field
dete-inany
any
benefits
surgical
outcome.
ular ular
pressure
(IOP)
and and
to prevent
further
visual
field
detebenefits
on on
surgical
outcome.
Financial Disclosure(s): The author(s) have
nopressure
proprietary
orprevent
commercial
interest
any
materials
discussed
1–5 1–5
rioration
in medically
uncontrolled
glaucoma.
However,
Preoperative
anti-inflammatory
treatment
alternarioration
in medically
uncontrolled
However,
Preoperative
anti-inflammatory
treatment
is is
an an
alternain this article. Ophthalmology 2010;117:1324
–1330
©
2010
by
the glaucoma.
American
Academy
of
Ophthalmology.
O que é conhecido
of main
the main
causes
of surgical
failure
is the
occurrence tivetive
or additional
approach
to counteract
fibrosis.
Bleb
failone one
of the
causes
of surgical
failure
is the
occurrence
or additional
approach
to counteract
fibrosis.
Bleb
failof excessive
postoperative
scarring
in the
region
of the ureure
been
associated
with
increasedconjunctival
conjunctival
of excessive
postoperative
scarring
in the
region
of the
hashas
been
associated
with
an an
increased
21–23
21–23
scleral
Many
adjunctive
antifibrotic
therapies
infiltration
of fibroblasts
inflammatory
cells.
Sevscleral
flap.flap.
Many
adjunctive
antifibrotic
therapies
to to infiltration
of fibroblasts
andand
inflammatory
cells.
Sevcounteract
this
conjunctival
scarring
have
been
investieral
studies
have
provided
evidence
that
the
long-term
counteract this conjunctival scarring have been investieral studies have provided evidence that the long-term useuse
6 –136 –13 Two common antifibrotic agents, mitomycin C
gated.
of could
IOP-lowering
medication
is associated
with
subclinical
gated.
Two common
antifibrotic
agents, mitomycin C
of IOP-lowering
is associated
with
subclinical
Trabeculectomy is the treatment of choice to reduce
intraocoperative
subconjunctival
fibrosis
notmedication
demonstrate
and
5-fluorouracil,
have
been
shown
to enhance
success conjunctival
conjunctival
inflammation.
This
inflammation
is assumed
19,20
and
5-fluorouracil,
have
been
shown
to
enhance
success
inflammation.
This
inflammation
is
assumed
to to
ular pressure (IOP) and to prevent further visual field
deteany benefits
on surgical
outcome.
9 –139 –13 These
rates
after
trabeculectomy.
agents
are
associ- contribute
contribute
to subconjunctival
scarring
and
subsequent
bleb
rates
after
trabeculectomy.
These
agents
are
associto
subconjunctival
scarring
and
subsequent
bleb
24 –30
24 –30
rioration in medically uncontrolled glaucoma.1–5ated
However,
Preoperative
anti-inflammatory
treatment
is surgery.
ansurgery.
alternaated
complications
as thin-walled
avascu- failure
failure
after
filtration
Based
aforemenwithwith
complications
suchsuch
as thin-walled
andand
avascuafter
filtration
Based
on on
thethe
aforemenlar blebs,
hypotony,
wound
leaks,
blebitis,
endophthalmitis,
tioned
findings,
it can
be
presumed
suppression
blebs,
hypotony,
wound
blebitis,
endophthalmitis,
tioned
findings,
it can
beBleb
presumed
thethe
suppression
of of
one of the main causes of surgical failure is the lar
occurrence
tive
orleaks,
additional
approach
to counteract
fibrosis.
fail-thatthat
14 –18
14 –18
scleral
melting.
Further
clinical
trials
using
anti– conjunctival
conjunctival
inflammation
caused
long-term
topical
IOPand and
scleral
melting.
Further
clinical
trials
using
anti–
inflammation
caused
by by
long-term
topical
IOPof excessive postoperative scarring in the region
of thegrowth
ure
has
associated
with
anlowering
increased
conjunctival
transforming
growth
factor
! been
antibodies
to counteract
post- lowering
treatment
may
help
to prevent
excessive
scartransforming
factor
! antibodies
to counteract
posttreatment
may
help
to prevent
thethe
excessive
scar-
scleral flap. Many adjunctive antifibrotic therapies to
infiltration of fibroblasts and inflammatory cells.21–23 Sev© 2010
the American
Academy
of Ophthalmology
ISSN
0161-6420/10/$–see
front
matter
counteract this conjunctival scarring have been
investieral
studies
have
provided evidence that the long-term ISSN
use
13241324
© 2010
by thebyAmerican
Academy
of Ophthalmology
0161-6420/10/$–see
front
matter
Published
by Elsevier
doi:10.1016/j.ophtha.2009.11.038
Published
by Elsevier
Inc. Inc.
doi:10.1016/j.ophtha.2009.11.038
6 –13
gated.
Two common antifibrotic agents, mitomycin C
of IOP-lowering medication is associated with subclinical
and 5-fluorouracil, have been shown to enhance success
conjunctival inflammation. This inflammation is assumed to
9 –13
rates after trabeculectomy.
These agents are associcontribute to subconjunctival scarring and subsequent bleb
ated with complications such as thin-walled and avascufailure after filtration surgery.24 –30 Based on the aforemenlar blebs, hypotony, wound leaks, blebitis, endophthalmitis,
tioned findings, it can be presumed that the suppression of
and scleral melting.14 –18 Further clinical trials using anti–
conjunctival inflammation caused by long-term topical IOPtransforming growth factor ! antibodies to counteract postlowering treatment may help to prevent the excessive scar-
O que é
desconhecido
1324
© 2010 by the American Academy of Ophthalmology
Published by Elsevier Inc.
O que
foi feito
ISSN 0161-6420/10/$–see front matter
doi:10.1016/j.ophtha.2009.11.038
Breusegem
et al ! NSAID or Steroid before Trabeculectomy
ring that leads to bleb failure after trabeculectomy. Therefore, a prospective, randomized, controlled clinical trial was
conducted to test this hypothesis with regard to clinical
outcomes.
Patients and Methods
This prospective, randomized, double-blind, placebo-controlled
clinical trial was approved by the Institutional Review Board of
University Hospitals Leuven, and it adhered to the tenets of the
Declaration of Helsinki. All eligible patients who agreed to participate in the study signed an informed consent before enrollment.
This study has been registered on www.clinicaltrials.gov (registration no. NCT00707421).
Between July 2005 and October 2007, consecutive patients
a purse-string technique. A combination preparation of tobramycin
and dexamethasone (Tobradex; Alcon) was applied as an ointment
at the end of the surgery and was continued as drops 4 times daily
for 8 weeks.
An individual target pressure was determined before surgery
based on a previously published formula.35,36 Patients were examined on days 1 and 2, at weeks 1, 2, and 4, and at months 3, 6, 12,
18, and 24 after trabeculectomy. All patients continued to be
followed up until all patients had completed their 2-year visit.
Snellen visual acuity measurements were converted to logarithm
of the minimum angle of resolution values enabling descriptive
calculations. Intraocular pressure was measured by Goldmann
applanation tonometry. If the IOP decreased insufficiently after
filtration surgery, needling, laser suture lysis, or needling revision
(in case of a flat bleb) was carried out or IOP-lowering medication
was restarted to reach the target IOP. Primary outcome measures
were incidence of additional surgical or medical interventions
AMERICAN JOURNAL OF OPHTHALMOLOGY
MARCH 2014
I
NTRAOCULAR PRESSURE (IOP) REDUCTION CAN SLOW
the progression of visual field (VF) damage in glaucoma
patients; however, despite apparently effective IOP
control, some patients continue to progress.1 It is well
known that IOP is higher in the supine position than
when sitting.2–6 Moreover, the extent of IOP elevation
from the sitting to the supine position is greater in
primary open-angle glaucoma (OAG), ocular hypertension, and normal-tension glaucoma (NTG) than in normal
subjects.6–8
In prospective studies of the effect of the lateral decubitus position on IOP in healthy volunteers, IOP in the
lateral decubitus position was consistently higher in the
dependent eye (the lower-positioned eye; eg, the right
eye in the right lateral decubitus position) than in the
nondependent eye (the upper-positioned eye; eg, the left
eye in the right lateral decubitus position).9–11 Further,
IOP in the dependent eye in the lateral decubitus
position was consistently higher than that in the sitting
or supine position.9–12 In 2 recent studies on OAG
patients, IOP in the lateral decubitus position was
consistently higher in the dependent eye than in the
fellow eye, and dependent-eye IOP was consistently higher
in the lateral decubitus position than in the sitting or
supine position.13,14
People generally spend between one-quarter and onethird of their lives sleeping. During sleep, body position
varies between the supine position and the lateral decubitus position, often more on 1 side than the other. Thus
IOP elevation related to the lateral decubitus position
might play a role in glaucoma progression.13,15,16
On the basis of questionnaire data, we previously suggested that the lateral decubitus position habitually
preferred by glaucoma patients might be associated with
asymmetric VF damage; however, the number of respondents was relatively small.13 In the present study, examining a large subject group, we verified our hypothesis on
the association between the preferred sleeping position
and asymmetric VF loss between eyes.
British Journal of Psychology (2013), 104, 225–234
© 2012 The British Psychological Society
www.wileyonlinelibrary.com
‘Beauty is in the eye of the beer holder’: People
who think they are drunk also think
they are attractive
Laurent Bègue1∗ , Brad J. Bushman2,3 , Oulmann Zerhouni1 ,
Baptiste Subra4 and Medhi Ourabah5
1
University of Grenoble 2, France
The Ohio State University, Columbus, Ohio, USA
3
VU University, Amsterdam, The Netherlands
4
University of Paris Descartes, France
5
University of Paris 8, Saint-Denis, France
2
Alcohol has many consequences on social perception and relationships. After a drink,
intoxicated people see members of the opposite sex through ‘beer goggles’, which makes
them look especially attractive (Jones, Jones, Thomas, & Piper, 2003; Lyvers, Cholakians,
Puorro, & Sundram, 2011; Neave, Tsang, & Heather, 2008). But alcohol can also influence
self-perceptions. Previous research on alcohol and self-awareness has found that alcohol
reduces self-awareness by inhibiting self-relevant encoding processes (Hull, Levenson,
Young, & Sher, 1983). The purpose of the present research is to test the hypothesis
that alcohol consumption increases self-perceived attractiveness. Whereas meta-analytic
reviews indicate that alcohol consumption enhances mood and sexual arousal (Hull &
Bond, 1986), the link between alcohol consumption and self-perceived attractiveness
remains to be clarified and theoretically developed.
• Conhecido - primeira parte - tema geral
do trabalho - vai do geral para o
específico
• Desconhecido - 1 frase - liga conhecido
com a questão
• O que foi feito - tema específico do
trabalho (ligado ao título e ao objetivo)
verbo no passado
• Descrição do artigo -verbo no presente
• Conhecido - primeira parte - tema geral
do trabalho - vai do geral para o
específico
A automatização da perimetria constituiu um passo fundamental para a
avaliação do campo visual, proporcionando um exame mais padronizado, mais
reprodutível e com menor influência do examinador(1-2). Na clínica diária, as
estratégias mais rápidas têm substituído as estratégias convencionais por
proporcionarem menor cansaço durante a realização do exame e uma menor
fadiga visual, gerando, conseqüentemente, resultados que representam com
maior fidelidade o campo de visão(3-5).
(...)
• Desconhecido - 1 frase - liga conhecido
com a questão
A automatização da perimetria constituiu um passo fundamental para a
avaliação do campo visual, proporcionando um exame mais padronizado, mais
reprodutível e com menor influência do examinador(1-2). Na clínica diária, as
estratégias mais rápidas têm substituído as estratégias convencionais por
proporcionarem menor cansaço durante a realização do exame e uma menor
fadiga visual, gerando, conseqüentemente, resultados que representam com
maior fidelidade o campo de visão(3-5).
(...)
A sensibilidade dessa estratégia tem sido avaliada em pacientes glaucomatosos
já familiarizados com o exame perimétrico e apresentou valores que variaram
de 83% a 100%(6,9-10), de acordo com a severidade do glaucoma. Até onde
conhecemos, não existe estudo que avalia a sensibilidade de SS
envolvendo pacientes sem experiência prévia com perimetria.
• Questão - tema específico do trabalho
(ligado ao título e ao objetivo)
O objetivo deste estudo é comparar as estratégias FT e SS em pacientes
glaucomatosos sem nenhuma experiência perimétrica prévia, determinando a
sensibilidade dessas estratégias no diagnóstico do glaucoma.
A automatização da perimetria constituiu um passo fundamental para a
avaliação do campo visual, proporcionando um exame mais padronizado, mais
reprodutível e com menor influência do examinador(1-2). Na clínica diária, as
estratégias mais rápidas têm substituído as estratégias convencionais por
proporcionarem menor cansaço durante a realização do exame e uma menor
fadiga visual, gerando, conseqüentemente, resultados que representam com
maior fidelidade o campo de visão(3-5).
(...)
A sensibilidade dessa estratégia tem sido avaliada em pacientes glaucomatosos
já familiarizados com o exame perimétrico e apresentou valores que variaram
de 83% a 100%(6,9-10), de acordo com a severidade do glaucoma. Até onde
conhecemos, não existe estudo que avalia a sensibilidade de SS
envolvendo pacientes sem experiência prévia com perimetria. O
objetivo deste estudo é comparar as estratégias FT e SS em pacientes
glaucomatosos sem nenhuma experiência perimétrica prévia, determinando a
sensibilidade dessas estratégias no diagnóstico do glaucoma.
Rui Barroso SchimitiI; Enyr Saran ArcieriII; Rodrigo Rezende AvelinoIII; Tiemi MatsuoIV;
Vital Paulino CostaV
População e o tipo de
estudo
• População: geralmente implícito no
texto mas pertence aos métodos
• Tipo do estudo: ligado ou após o que
foi feito
tive or additional approach to counteract fibrosis. Bleb failure has been associated with an increased conjunctival
21–23
infiltration of fibroblasts and inflammatory cells.
Several studies have provided evidence that the long-term use
of IOP-lowering medication is associated with subclinical
conjunctival inflammation. This inflammation is assumed to
contribute to subconjunctival scarring and subsequent bleb
failure after filtration surgery.24 –30 Based on the aforementioned findings, it can be presumed that the suppression of
Breusegem
et al ! topical
NSAID
or St
conjunctival inflammation caused
by long-term
IOPlowering treatment may help to prevent the excessive scarring that leads to bleb failure after trabeculectomy. Therefore, a prospective, randomized, ISSN
controlled
clinical trial
was
0161-6420/10/$–see
front matter
doi:10.1016/j.ophtha.2009.11.038
conducted to test this hypothesis with
regard to clinical
outcomes.
População e o tipo de
estudo
Referências
“Se eu fui capaz de ver mais longe é porque
estava em pé nos ombros de gigantes.”
Discurso de Martin Luther King
Discurso realizado por Martin Luther King sobre as escadarias do Monumento
Abraham Lincoln em Washington D.C..
Há cem anos, um grande americano, sob cuja sombra
simbólica nos encontramos, assinava a Proclamação da
Emancipação. Esse decreto fundamental foi como um raio
de luz de esperança para milhões de escravos negros que
tinham sido marcados a ferro nas chamas de uma
vergonhosa injustiça. Veio como uma aurora feliz para
terminar a longa noite do cativeiro. Mas, cem anos mais
tarde, devemos enfrentar a realidade trágica de que o
Negro ainda não é livre.
Referências
• Poucas e de preferência as mais
relevantes para o assunto
Alcohol has many consequences on social perception and relationships. After a drink,
intoxicated people see members of the opposite sex through ‘beer goggles’, which makes
them look especially attractive (Jones, Jones, Thomas, & Piper, 2003; Lyvers, Cholakians,
Puorro, & Sundram, 2011; Neave, Tsang, & Heather, 2008). But alcohol can also influence
self-perceptions. Previous research on alcohol and self-awareness has found that alcohol
reduces self-awareness by inhibiting self-relevant encoding processes (Hull, Levenson,
Young, & Sher, 1983). The purpose of the present research is to test the hypothesis
that alcohol consumption increases self-perceived attractiveness. Whereas meta-analytic
reviews indicate that alcohol consumption enhances mood and sexual arousal (Hull &
Bond, 1986), the link between alcohol consumption and self-perceived attractiveness
remains to be clarified and theoretically developed.
• A declaração de Helsinki determina que
estudos em humanos têm que se basear
no conhecimento da literatura
• metanálise citada ou ausência de
trabalhos
Importância do estudo
• Implícito no texto ou declarada
diretamente.
• Cuidado com afirmações de ineditismo!
(...) Até onde conhecemos, não existe estudo que avalia a sensibilidade
de SS envolvendo pacientes sem experiência prévia com perimetria. O
objetivo deste estudo é comparar as estratégias FT e SS em pacientes
glaucomatosos sem nenhuma experiência perimétrica prévia, determinando a
sensibilidade dessas estratégias no diagnóstico do glaucoma.
Cuidado com falsos
sinônimos e cognatos
• Actually, but not until last year, laser cataract surgery
is ... (de fato)
• The questionary applicant was a very comprehensive
man. (gordo?)
• I’m afraid to be equivocated about the results
(mentiroso)
• An investigator must attend the hole experiment as a
positive result could eventually happens (só no final)
• The sample was placed in the recipient (no receptor)
Ponto e Contraponto
‘Beauty is in the eye of the beer holder’: People
who think they are drunk also think
they are attractive
Laurent Bègue1∗ , Brad J. Bushman2,3 , Oulmann Zerhouni1 ,
Baptiste Subra4 and Medhi Ourabah5
1
University of Grenoble 2, France
The Ohio State University, Columbus, Ohio, USA
3
VU University, Amsterdam, The Netherlands
4
University of Paris Descartes, France
5
University of Paris 8, Saint-Denis, France
2
Alcohol has many consequences on social perception and relationships. After a drink,
intoxicated people see members of the opposite sex through ‘beer goggles’, which makes
them look especially attractive (Jones, Jones, Thomas, & Piper, 2003; Lyvers, Cholakians,
Puorro, & Sundram, 2011; Neave, Tsang, & Heather, 2008). But alcohol can also influence
self-perceptions. Previous research on alcohol and self-awareness has found that alcohol
reduces self-awareness by inhibiting self-relevant encoding processes (Hull, Levenson,
Young, & Sher, 1983). The purpose of the present research is to test the hypothesis
that alcohol consumption increases self-perceived attractiveness. Whereas meta-analytic
reviews indicate that alcohol consumption enhances mood and sexual arousal (Hull &
Bond, 1986), the link between alcohol consumption and self-perceived attractiveness
remains to be clarified and theoretically developed.
The Steroids for Corneal Ulcers Trial (SCUT): Secondary
12-Month Clinical Outcomes of a Randomized
Controlled Trial
MUTHIAH SRINIVASAN, JEENA MASCARENHAS, REVATHI RAJARAMAN, MEENAKSHI RAVINDRAN,
PRAJNA LALITHA, KIERAN S. O’BRIEN, DAVID V. GLIDDEN, KATHRYN J. RAY, CATHERINE E. OLDENBURG,
MICHAEL E. ZEGANS, JOHN P. WHITCHER, STEPHEN D. MCLEOD, TRAVIS C. PORCO, THOMAS M. LIETMAN,
AND NISHA R. ACHARYA, FOR THE STEROIDS FOR CORNEAL ULCERS TRIAL GROUP
for bacterial corneal ulcers.
In order to provide further evidence to guide treatment
practices, the Steroids for Corneal Ulcers Trial (SCUT)
assessed the effect of adjunctive corticosteroids on clinical
outcomes in patients with bacterial corneal ulcers. The primary outcome of this trial revealed no benefit of adjunctive
Overall, SCUT found no difference in clinical outcomes
at 3 months between patients using corticosteroids vs pla15
cebo, but differences may arise after a longer period of
time. It is possible that clinical benefits with corticosteroids
are not seen until later because of delayed healing or effects
Discurso de Martin Luther King
Discurso realizado por Martin Luther King sobre as escadarias do Monumento
Abraham Lincoln em Washington D.C..
Há cem anos, um grande americano, sob cuja sombra
simbólica nos encontramos, assinava a Proclamação da
Emancipação. Esse decreto fundamental foi como um raio
de luz de esperança para milhões de escravos negros que
tinham sido marcados a ferro nas chamas de uma
vergonhosa injustiça. Veio como uma aurora feliz para
terminar a longa noite do cativeiro. Mas, cem anos mais
tarde, devemos enfrentar a realidade trágica de que o
Negro ainda não é livre.
Conhecido
Pigs are well known for their house construction
abilities. They use it for shelter and to prevent
predator attacks(1). A pig house can be built out of
straw, sticks, or bricks. Straw and sticks are cheaper
and easier to use, but bricks usually provide tougher
houses(2). The european black wolf is considered to
be a very efficient predator. Black wolves are known
to destroy pig houses leading to pig casualty in two
out of three attempts(3).
Desconhecido
Although, epidemiological data suggests an
association between house material and pig’s
lifespan(4), there’s no strong evidence connecting
pig's house resilience and successful black wolf
attacks.
Pergunta - o que foi
feito
Therefore, we examined the protection abilities of
three different pig houses (made with straw, sticks,
or bricks) against a single hungry european black
wolf.
Resumo
• Introdução: curta, clara e cativante
• Funil
• Sabe, não sabe, pergunta
• Cuidado com erros
• Ponto e contra-ponto
Obrigado!