Cílem studie je nejen určit přesné zrakové funkce (log MÚR, KC) a zhodnotit topografické mapy rohovky u pacientů s prokázaným Sjögrenovým syndromem (laboratorně a biopticky), ale zároveň zjistit změnu subjektivních obtíží před a po zavedení intrakanalikulárních implantátů. Pacienti a metodika: 12 očí (1 muž, 6 žen) s prokázaným Sjögrenovým syndromem bylo vyšetřeno předoperačně a během 2 měsíců po operačním zákroku. Prahová NKZO byla testována na tabulích s Landoltovými prstenci, KC byla měřena na počítačem ovládaném zařízení typu (Neuroscientific. Corp. USA) v 6 prostorových frekvencích (0,74-29,55 c/deg). Změny keratotopografu (Keratron Optikon) jsme určili porovnáním hodnot celkových aberací oka před a po zavedení intrakanalikulárních implantátů typu Smart Plug. Kontrolní skupinu pro hodnocení zrakových funkcí tvořilo 10 žen (20 očí) stejného středního věku). Výsledky: NKZO na log MÚR tabulích byla předoperačně 0,84 (0,69–0,95) a 0,88 (0,52–1,23) pooperačně; v porovnání s kontrolní skupinou je nižší v obou sledovaných termínech. KC je předoperačně ve všech prostorových frekvencích nižší, největší rozdíly jsou ve frekvencích 1,97–7,29 c/deg p < 0,01, po zákroku se hodnoty zvyšují, ale nedosahují úrovně kontrolní skupiny. Subjektivní obtíže pacientů významně poklesly, pacienti ve 100 % pociťují úlevu, ve třech případech udávají zlepšení asi o 50 %, žádný pacient nepozoroval pocit přeslzení. Frekvence kapání se snížila o 63 %. Schirmerův test, který byl před zákrokem ve 100 % pozitivní, je po zákroku v 75 % negativní, výška slzného menisku, která byla před zákrokem ve 100 % pozitivní, po operačním zákroku se zlepšila v 91 % na 1 mm, v 9 % na 1,5 mm. Rovněž jsme zaznamenali změny povrchu oka při barvení lissaminovou zelení, kdy tento test před zákrokem byl ve 100 % pozitivní, zlepšení po zákroku jsme pozorovali v 63 %. Pravidelnost rohovkového povrchu je určujícím faktorem zrakových funkcí u „suchého oka“. Měření topografie rohovky je užitečné v diferenciální diagnostice a rozlišení lehkých a středně těžkých forem suchého oka. Zlepšení NKZO a KC pooperačně je v souladu se subjektivním hodnocením pacientů. Největším přínosem léčby je zlepšení komfortu nemocných; navíc po zavedení trvalých implantátů pacienti udávají zřetelnou subjektivní úlevu a značné snížení nutnosti kapání umělých slz do spojivkového vaku.
The aim of the study was to determine exact visual functions (log MAR [minimal angle of resolution] and CS [contrast sensitivity]) and to evaluate corneal topographic maps in patients with established (by means of laboratory and biopsy examinations) Sjögren's Syndrome, and to determine the difference in subjective symptoms before and after insertion of the intracanalicular implants as well. Patients and methods: Twelve eyes (1 man, 6 women) with established Sjögren's syndrome were examined before and during two months after the insertion of the plugs. The best-corrected visual acuity (BCVA) was assessed on Landolt C rings optotypes. CS was measured on computer-controlled device (Neuroscientific Corp., U.S.A.) in 6 space-frequencies (0.74–29.55 c/deg). The corneal topographic changes (Keraton Opticon) were established by means of comparing total aberrations values before and after the intracanalicular implants' (Smart Plugs type) insertion. The control group for visual functions assessment consisted of 10 woman (20 eyes) of similar middle age. Results: The BCVA on log MAR optotypes was 0.84 (0.69–0.95) before and 0.88 (0.52–1.23) after the insertion, on both occasions, it was lower than in the control group. The CS was before the insertion in all of the spatial frequencies lower, the largest differences were in the frequencies range 1.97–7.29 c/deg (p < 0.01). After the treatment, the values grow but they don't reach the values of the control group. Subjective complains of the patients decreased markedly; in 100 % they had relief, in 3 cases they referred improvement up to 50 %; no patient observed tearing. The frequency of drops' application has decreased by 63 %. The Schirmer test, in 100 % positive before the treatment, was after the insertion in 75 % negative; the height of the tear-meniscus was positive in 100 % before the procedure, and after that, its measurement improved to 1 mm in 91 %; in 9 % it was 1.5 mm. We also noticed changes of the ocular surface by means of lissamine green staining; this test was before the procedure positive in 100 %, the improvement after that was in 63 %. The regularity of the corneal surface is the determining factor of visual functions in “dry eyes”. The measurement of the corneal topography is useful in differential diagnosis and helps to distinguish mild and more serious conditions of dry eye. The improvement of BCVA and CS values after insertion corresponds with patients' subjective evaluating. The best value of the treatment is improvement of the patients' comfort; furthermore, after insertion of the permanent plugs they feel pronounced subjective relief and lowering of the frequency of drops application.
- Keywords
- Smart Plug,
- MeSH
- Dacryocystorhinostomy MeSH
- Diagnostic Techniques, Ophthalmological utilization MeSH
- Humans MeSH
- Lacrimal Duct Obstruction therapy MeSH
- Prostheses and Implants utilization MeSH
- Corneal Topography utilization MeSH
- Sjogren's Syndrome diagnosis complications MeSH
- Dry Eye Syndromes physiopathology MeSH
- Check Tag
- Humans MeSH
- Publication type
- Evaluation Study MeSH
Smart hydrogels are special type of hydrogels that undergo solution-gelation transition in response to alterations in the environment. Solution-gel transformation is brought about through either physical or chemical cross-linking that occur between the hydrogel chains. Various stimulating factors have been identified to be responsible for the change in the physical state of the intelligent hydrogel. The most important triggering factors are the temperature, pH, ions, electrical signalling, magnetic field, glucose, light and others. Each of these stimulating factors can trigger the swelling of the hydrogel through unique mechanism. Many of these triggering factors are characteristics of the biological systems which make the smart polymers quite beneficial for different biomedical applications. Numerous natural and synthetic polymers have been distinguished to act as smart materials. These polymers impressed the scientists to use them in many biomedical and industrial applications such as drug delivery systems, gene therapy applications, tissue engineering and many other applications.
The design of smart surfaces with externally triggerable water/oil wettability and adhesion represents one of the most up-to-date challenges in the field of material science. In this work, the intelligent surface with electrically triggerable wettability and water/oil adhesion is presented. As a basic material background exhibiting electric field (EF) sensitivity, the piezo-responsive polymethylmethacrylate/polyvinylidenefluoride polymer fibers were used. To expand the available range of water/oil contact angles (CAs) and adhesion, the fibers were grafted with hydrophilic or hydrophobic functional groups using diazonium chemistry. The fiber functionality was evaluated using the static CA and wettability hysteresis measurements (increasing/decreasing drop volume and tilting angles), drops adhesion/repellence and graphite self-cleaning test performed with and without the application of EF. It was found that the proposed method enables tuning the surface wettability in the superhydrophobic/superoleophobic-hydrophilic/oleophilic range and changing of surface properties from low adhesive to high adhesive for water and oil. More convincing results were achieved in the case of fiber surface modification by ADT-C8F17, which may result from a rearrangement of the grated -C6H4C8F17 functional group under the application of EF triggering. Moreover, the triggering which can be performed in the extremely fast way (the surface responds to the EF switching on/off in seconds) was found to be fully reversible. Finally, the additional tests indicate the satisfactory stability of created fiber-based coating against the mechanical treatment.
- MeSH
- Humans MeSH
- Evidence-Based Medicine statistics & numerical data MeSH
- Prostatic Neoplasms diagnosis epidemiology mortality MeSH
- Digital Rectal Examination utilization MeSH
- Mass Screening methods organization & administration instrumentation MeSH
- Prostate-Specific Antigen analysis MeSH
- Randomized Controlled Trials as Topic MeSH
- Practice Guidelines as Topic MeSH
- Ultrasound, High-Intensity Focused, Transrectal utilization MeSH
- Check Tag
- Humans MeSH
- Male MeSH
"Smart city", "sustainable city", "ubiquitous city", "smart sustainable city", "eco-city", "regenerative city" are fuzzy concepts; they are established to mitigate the negative impact on urban growth while achieving economic, social, and environmental sustainability. This study presents the result of the literature network analysis exploring the state of the art in the concepts of smart and regenerative urban growth under urban metabolism framework. Heat-maps of impact citations, cutting-edge research on the topic, tip-top ideas, concepts, and theories are highlighted and revealed through VOSviewer bibliometrics based on a selection of 1686 documents acquired from Web of Science, for a timespan between 2010 and 2019. This study discloses that urban growth is a complex phenomenon that covers social, economic, and environmental aspects, and the overlaps between them, leading to a diverse range of concepts on urban development. In regards to our concepts of interest, smart, and regenerative urban growth, we see that there is an absence of conceptual contiguity since both concepts have been approached on an individual basis. This fact unveils the need to adopt a more holistic and interdisciplinary approach to urban planning and design, integrating these concepts to improve the quality of life and public health in urban areas.
- MeSH
- Quality of Life * MeSH
- Urban Renewal * MeSH
- City Planning * MeSH
- Sustainable Development MeSH
- Cities MeSH
- Public Health MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Review MeSH
- Geographicals
- Cities MeSH
9th compl. revis. nurses ed. 375 s.
Fixní kombinaci budesonid+formoterol lze podávat, vedle konvenčního fixního nebo flexibilního režimu, také v režimu SMART, kdy je tato kombinace používána zejména k udržovací a současně i k úlevové léčbě. Klíčem k dosažení významné efektivity režimu SMART je „správná dávka ve správný čas”, což vede k zastavení vývoje, resp. vzniku exacerbace. Režim SMART přináší efekt zjednodušení léčby perzistujícího astmatu, a to jak pro pacienta, tak pro lékaře, zejména pak u pacienta s vyjádřenou výraznější variabilitou tíhy astmatu v závislosti na různých provokujících faktorech – jako v případě uvedené kazuistiky.
Fixed combination of budesonid and formoterol is possible to be used as standard fixed or flexible schema but also in schema called SMART, where it is used as maintenance therapy and at the same time as therapy of relief. The key of efficiency of SMART schema is “the accurate dose in accurate time”, that causes termination of progress or developing of asthma exacerbation. SMART schema brings to the therapy of persistent asthma more simplicity as to the patient as to the physician, especially in cases of large variability of asthma presentation depending on various factors of provocation – as in our casuistry.
- MeSH
- Adrenergic beta-2 Receptor Agonists pharmacology MeSH
- Asthma * diagnosis drug therapy MeSH
- Bronchodilator Agents pharmacology classification MeSH
- Budesonide pharmacology MeSH
- Adult MeSH
- Ethanolamines pharmacology MeSH
- Humans MeSH
- Food Hypersensitivity MeSH
- Respiratory Function Tests methods utilization MeSH
- Rhinitis, Allergic, Seasonal * diagnosis drug therapy MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Female MeSH
- Publication type
- Case Reports MeSH
