ABSTRACT Objective: Various studies have shown that diabetes mellitus (DM) increases the risk of thrombosis in the venous system as well as in the arterial system. In this study, it was aimed to evaluate the association between admission blood glucose levels and clinical severity, recurrence, and mortality in pulmonary embolism in patients with DM. Materials and methods: This study was designed as a retrospective cross-sectional study. Patients with DM who were admitted to a tertiary care hospital due to pulmonary embolism (PE) between 2014 and 2019 were included. Demographic characteristics, radiological findings, clinical class of embolism, and mortality data were retrieved from hospital records. Patients with and without recurrent disease, as well as patients who survived and died, were compared. Also, patients were classified according to quartiles of admission blood glucose levels. The quartiles were compared in terms of mortality, clinical, class, and recurrence. Results: Two hundred ninety-three patients with DM and PE were included in the study. Patients with adverse outcome had significantly higher admission blood glucose levels (respectively, 197.9 ± 96.30 mg/dL vs. 170.7 ± 74.26 mg/dL; p = 0.03). Patients in the third and fourth quartile of admission blood glucose levels (>152 mg/dL) had significantly more severe disease with a higher proportion of massive and sub-massive PE and higher pro-BNP levels (respectively, p = 0.01 and 0.02). Conclusion: Non-survived patients and recurrent disease were associated with higher admission blood glucose levels. Also, patients with admission blood glucose levels higher than 152 mg/dL tend to have clinically more severe diseases.

SUMMARY Objective: Myocardial infarction has unfavorable effect on structural and functional properties of the myocardium, referred to as cardiac remodeling. Left ventricular mass, left ventricular mass index, and relative wall thickness are important predictors of cardiac remodeling. In this study, we investigated the effect of candesartan treatment in comparison with zofenopril treatment on echocardiographic indices of cardiac remodeling in post myocardial infarction patients. Material and Methods: In this prospective study, patients who underwent successful percutaneous coronary intervention were randomly assigned to a candesartan or zofenopril treatment. After randomization, echocardiographic indices of cardiac remodeling including left ventricular mass, left ventricular mass index, and relative wall thickness were evaluated before the start of treatment along with 1- and 6-month follow-ups. Results: According to our study, candesartan group showed significant reduction of estimated left ventricular mass and left ventricular mass index at 6-month follow-up visit compared to baseline values (199.53±38.51 g vs. 212.69±40.82 g; 99.05 g/m2 (90.00–116.5) vs. 106.0 g/m2 (96.0∼123.00), p<0.05, respectively). This trend was also observed in zofenopril group during the 6-month period (201.22±40.07 g vs. 207.52±41.61 g; 101.0 g/m2 (92.25–111.75.0) vs. 104.50 g/m2 (95.0∼116.75), p<0.05, respectively). Although both classes of drugs had favorable effects on post-myocardial infarction cardiac remodeling, the absolute benefit was more prominent in candesartan group as compared to zofenopril group (p<0.05). Conclusion: Our results suggest that candesartan treatment following myocardial infarction may potentially be useful in terms of improving post-myocardial infarction cardiac remodeling.

ABSTRACT Objective: To compare the effects of a home-based pulmonary rehabilitation (PR) program with and without telecoaching on health-related outcomes in COVID-19 survivors. Methods: A total of 42 COVID-19 patients who completed medical treatment were randomly divided into two groups: the study (telecoaching) group (n = 21) and the control (no telecoaching) group (n = 21). Both groups participated in an 8-week home-based PR program including education, breathing exercises, strength training, and regular walking. The study group received phone calls from a physiotherapist once a week. Both groups of patients were assessed before and after the program by means of the following: pulmonary function tests; the modified Medical Research Council dyspnea scale; the six-minute walk test; extremity muscle strength measurement; the Saint George’s Respiratory Questionnaire (to assess disease-related quality of life); the Medical Outcomes Study 36-item Short-Form Health Survey (SF-36, to assess overall quality of life); and the Hospital Anxiety and Depression Scale. Results: In both groups, there were significant improvements in the following: FVC; the six-minute walk distance; right and left deltoid muscle strength; Saint George’s Respiratory Questionnaire activity domain, impact domain, and total scores; and SF-36 social functioning, role-physical, role-emotional, and bodily pain domain scores (p < 0.05). Decreases in daily-life dyspnea, exertional dyspnea, and exertional fatigue were significant in the study group (p < 0.05), and the improvement in SF-36 social functioning domain scores was greater in the study group (p < 0.05). Conclusions: A home-based PR program with telecoaching increases social functioning and decreases daily-life dyspnea, exertional dyspnea, and exertional fatigue in COVID-19 survivors in comparison with a home-based PR program without telecoaching.

RESUMO Objetivo: Comparar os efeitos de um programa de reabilitação pulmonar (RP) domiciliar com e sem coaching por telefone (telecoaching) nos desfechos relacionados à saúde em sobreviventes da COVID-19. Métodos: Um total de 42 pacientes com COVID-19 que completaram o tratamento médico foram aleatoriamente divididos em dois grupos: o grupo com telecoaching (grupo de estudo; n = 21) e o grupo sem telecoaching (grupo controle; n = 21). Ambos os grupos participaram de um programa de RP domiciliar que teve 8 semanas de duração e incluiu educação, exercícios respiratórios, treinamento de força e caminhada regular. O grupo de estudo recebeu telefonemas de um fisioterapeuta uma vez por semana. Ambos os grupos foram avaliados antes e depois do programa por meio de testes de função pulmonar, escala modificada de dispneia do Medical Research Council, teste de caminhada de seis minutos, mensuração da força muscular dos membros superiores e inferiores, Saint George’s Respiratory Questionnaire (para avaliar a qualidade de vida relacionada à doença), Medical Outcomes Study 36-item Short-Form Health Survey (SF-36, para avaliar a qualidade de vida global) e Hospital Anxiety and Depression Scale. Resultados: Em ambos os grupos, houve melhoria significativa da CVF; da distância percorrida no teste de caminhada de seis minutos; da força dos músculos deltoides direito e esquerdo; da pontuação obtida nos domínios “atividade” e “impacto” do Saint George’s Respiratory Questionnaire, bem como da pontuação total no questionário; e da pontuação obtida nos domínios “aspectos sociais”, “função física”, “função emocional” e “dor corporal” do SF-36 (p < 0,05). A redução da dispneia na vida diária, da dispneia aos esforços e da fadiga aos esforços foi significativa no grupo de estudo (p < 0,05), e a melhoria da pontuação obtida no domínio “aspectos sociais” do SF-36 foi maior no grupo de estudo (p < 0,05). Conclusões: Um programa de RP domiciliar com telecoaching melhora os aspectos sociais e diminui a dispneia na vida diária, a dispneia aos esforços e a fadiga aos esforços em sobreviventes da COVID-19 em comparação com um programa de RP domiciliar sem telecoaching.

ABSTRACT Purpose: To evaluate the visual acuity of healthy and amblyopic children using sweep visual evoked potential and compare the results with those of Snellen visual acuity testing. Methods: A total of 160 children aged 6-17 years were included in the study. Of these, 104 (65%) were aged 7-17 years old, able to verbally communicate, and did not have any systemic or ocular pathology (Group 1). Group 2 included 56 (35%) children aged 6-17 years, able to verbally communicate, and had strabismus or anisometropic amblyopia whose best corrected visual acuity was between 0.1 and 0.8. All subjects underwent a detailed ophthalmological examination and sweep visual evoked potential measurement. Demographic characteristics, ocular findings, best corrected visual acuity, and sweep visual evoked potential results were recorded. Results: In Group 1, the mean and maximum visual acuity values for sweep visual evoked potential were lower than the Snellen best corrected visual acuity (p<0.001, for both, respectively). Bland-Altman analysis revealed that in Group 1, the distribution of the differences between the Snellen best corrected visual acuity and mean sweep visual evoked potential visual acuity was ±0.11 logMAR, and the distribution of the differences between the Snellen best corrected visual acuity and maximum sweep visual evoked potential visual acuity was ±0.023 logMAR. In Group 2, the mean and maximum sweep visual evoked potential visual acuity were lower than the Snellen best corrected visual acuity (p<0.001 and p=0.009, respectively). Bland-Altman analysis revealed that the distribution of the differences between the Snellen best corrected visual acuity and mean sweep visual evoked potential visual acuity was ±0.16 logMAR, and the distribution of the differences between the Snellen best corrected visual acuity and maximum sweep visual evoked potential visual acuity was ±0.19 logMAR. Conclusions: Sweep visual evoked potential visual acuity measurements have comparable results with Snellen visual acuity measurements. This technique is an objective and reliable method for evaluating visual acuity in children.

RESUMO Objetivo: Avaliar a acuidade visual através de potenciais evocados visuais de varredura em crianças saudáveis e ambliópicas, comparando-a com a acuidade visual pelo teste de Snellen. Métodos: Foram incluídas no estudo 160 crianças com idades entre 6 e 17 anos. Desse total, 104 crianças (65%) estavam entre 7 e 17 anos de idade, eram capazes de comunicação verbal e não tinham nenhuma patologia ocular ou sistêmica (Grupo 1). O grupo 2 incluiu 56 crianças verbais (35%) com idades entre 6 e 17 anos e portadoras de estrabismo ou ambliopia anisometrópica, com a melhor acuidade visual corrigida entre 0,1 e 0,8. Todos os pacientes foram submetidos a um exame oftalmológico detalhado e a uma medição do potencial evocado visual por varredura. Registraram-se as características demográficas, os achados oculares, a melhor acuidade visual corrigida e os resultados do potencial evocado visual por varredura. Resultados: No Grupo 1, os valores médios e máximos da acuidade visual pelo potencial evocado visual por varredura mostraram-se menores que a melhor acuidade visual corrigida medida através do teste de Snellen (p<0,001 para ambas as medições). Uma análise de Bland-Altman revelou que no grupo 1, a distribuição das diferenças entre a melhor acuidade visual corrigida pelo teste de Snellen e a média do potencial evocado visual por varredura foi de ± 0,11 logMAR, enquanto a distribuição das diferenças entre a melhor acuidade visual corrigida pelo teste de Snellen e o valor máximo do potencial evocado visual por varredura foi de ± 0,023 logMAR. No Grupo 2, os valores médio e máximo do potencial evocado visual por varredura mostraram-se menores que a melhor acuidade visual corrigida pelo teste de Snellen (respectivamente, p<0,001 e p=0,009). A análise de Bland-Altman revelou que a distribuição das diferenças entre a melhor acuidade visual corrigida pelo teste de Snellen e a média do potencial evocado visual por varredura foi de ± 0,16 logMAR, enquanto a distribuição das diferenças entre a melhor acuidade visual corrigida pelo teste de Snellen e o valor máximo do potencial evocado visual por varredura foi de ± 0,19 logMAR. Conclusões: As medidas da acuidade visual através do potencial evocado visual por varredura mostram resultados comparáveis às medidas da acuidade visual pelo teste de Snellen. Essa técnica é um método objetivo e confiável de se avaliar a acuidade visual em crianças.

ABSTRACT Objetivo: Maturity onset diabetes of the young (MODY) patients have clinical heterogeneity as shown by many studies. Thus, often it is misdiagnosed to type 1 or type 2 diabetes(T2DM). The aim of this study is to evaluate MODY mutations in adult T2DM patients suspicious in terms of MODY, and to show clinical and laboratory differences between these two situations. Subjects and methods: In this study, we analyzed 72 type 2 diabetic patients and their relatives (35F/37M) who had been suspected for MODY and referred to genetic department for mutation analysis. The gene mutations for MODY have been assessed in the laboratory of Marmara University genetics. Totally 67 (32F/35M; median age 36.1) diabetic patients were analyzed for 7 MODY mutations. Twelve patients who have uncertain mutation (VUS) were excluded from study for further evaluation. MODY(+) (n:30) patients and T2DM patients (n:25) were compared for clinical and laboratory parameters. Results: In MODY(+) subjects, mutations in GCK (MODY 2) (n:12; 40%) were the most common followed by HNF4A (MODY 1) (n:4; 13.3%). Diabetes diagnosis age was younger in MODY(+) group but not statistically significant. Sixty-six percent of MODY(+) subjects had diabetes history at 3-consecutive generations in their family compared with 28% of T2DM patients statistically significant (p:0.006). Gender, BMI, C-peptide, HbA1c, lipid parameters, creatinine, GFR, microalbuminuria, vitamin D and calcium were not statistically different between the groups. Conclusion: According to present study results, MODY mutation positivity is most probable in young autoantibody (-) diabetic patients diagnosed before 30 years of age, who have first degree family history of diabetes.

RESUMO Objetivo: Avaliar a acuidade visual através de potenciais evocados visuais de varredura em crianças saudáveis e ambliópicas, comparando-a com a acuidade visual pelo teste de Snellen. Métodos: Foram incluídas no estudo 160 crianças com idades entre 6 e 17 anos. Desse total, 104 crianças (65%) estavam entre 7 e 17 anos de idade, eram capazes de comunicação verbal e não tinham nenhuma patologia ocular ou sistêmica (Grupo 1). O grupo 2 incluiu 56 crianças verbais (35%) com idades entre 6 e 17 anos e portadoras de estrabismo ou ambliopia anisometrópica, com a melhor acuidade visual corrigida entre 0,1 e 0,8. Todos os pacientes foram submetidos a um exame oftalmológico detalhado e a uma medição do potencial evocado visual por varredura. Registraram-se as características demográficas, os achados oculares, a melhor acuidade visual corrigida e os resultados do potencial evocado visual por varredura. Resultados: No Grupo 1, os valores médios e máximos da acuidade visual pelo potencial evocado visual por varredura mostraram-se menores que a melhor acuidade visual corrigida medida através do teste de Snellen (p<0,001 para ambas as medições). Uma análise de Bland-Altman revelou que no grupo 1, a distribuição das diferenças entre a melhor acuidade visual corrigida pelo teste de Snellen e a média do potencial evocado visual por varredura foi de ± 0,11 logMAR, enquanto a distribuição das diferenças entre a melhor acuidade visual corrigida pelo teste de Snellen e o valor máximo do potencial evocado visual por varredura foi de ± 0,023 logMAR. No Grupo 2, os valores médio e máximo do potencial evocado visual por varredura mostraram-se menores que a melhor acuidade visual corrigida pelo teste de Snellen (respectivamente, p<0,001 e p=0,009). A análise de Bland-Altman revelou que a distribuição das diferenças entre a melhor acuidade visual corrigida pelo teste de Snellen e a média do potencial evocado visual por varredura foi de ± 0,16 logMAR, enquanto a distribuição das diferenças entre a melhor acuidade visual corrigida pelo teste de Snellen e o valor máximo do potencial evocado visual por varredura foi de ± 0,19 logMAR. Conclusões: As medidas da acuidade visual através do potencial evocado visual por varredura mostram resultados comparáveis às medidas da acuidade visual pelo teste de Snellen. Essa técnica é um método objetivo e confiável de se avaliar a acuidade visual em crianças.

ABSTRACT Purpose: To evaluate the visual acuity of healthy and amblyopic children using sweep visual evoked potential and compare the results with those of Snellen visual acuity testing. Methods: A total of 160 children aged 6-17 years were included in the study. Of these, 104 (65%) were aged 7-17 years old, able to verbally communicate, and did not have any systemic or ocular pathology (Group 1). Group 2 included 56 (35%) children aged 6-17 years, able to verbally communicate, and had strabismus or anisometropic amblyopia whose best corrected visual acuity was between 0.1 and 0.8. All subjects underwent a detailed ophthalmological examination and sweep visual evoked potential measurement. Demographic characteristics, ocular findings, best corrected visual acuity, and sweep visual evoked potential results were recorded. Results: In Group 1, the mean and maximum visual acuity values for sweep visual evoked potential were lower than the Snellen best corrected visual acuity (p<0.001, for both, respectively). Bland-Altman analysis revealed that in Group 1, the distribution of the differences between the Snellen best corrected visual acuity and mean sweep visual evoked potential visual acuity was ±0.11 logMAR, and the distribution of the differences between the Snellen best corrected visual acuity and maximum sweep visual evoked potential visual acuity was ±0.023 logMAR. In Group 2, the mean and maximum sweep visual evoked potential visual acuity were lower than the Snellen best corrected visual acuity (p<0.001 and p=0.009, respectively). Bland-Altman analysis revealed that the distribution of the differences between the Snellen best corrected visual acuity and mean sweep visual evoked potential visual acuity was ±0.16 logMAR, and the distribution of the differences between the Snellen best corrected visual acuity and maximum sweep visual evoked potential visual acuity was ±0.19 logMAR. Conclusions: Sweep visual evoked potential visual acuity measurements have comparable results with Snellen visual acuity measurements. This technique is an objective and reliable method for evaluating visual acuity in children.

RESUMO Objetivo: Avaliar, depois de 30 meses, a função visual e as alterações na espessura macular central de pacientes com degeneração macular relacionada à idade sem resposta terapêutica ao ranibizumabe (Lucentis®) que mudaram seu tratamento para o aflibercepte (Eylea®). Métodos: Realizou-se um estudo retrospectivo de pacientes com degeneração macular neovascular relacionada à idade que mudaram o tratamento para o aflibercepte após 6 ou mais injeções intravítreas de ranibizumabe a intervalos de 4-8 semanas. Todos os pacientes mudaram para o aflibercepte intravítreo (2,0 mg) e depois de 3 injeções consecutivas, seguidas de um regime de dosagem pro re nata, foram avaliados após 30 meses de tratamento. A melhor acuidade visual corrigida, o exame biomicroscópico, a pressão intraocular, a fundoscopia e a espessura macular central foram registrados no início do tratamento, antes da transição para o tratamento com aflibercepte intravítreo e aos 6, 12, 18, 24 e 30 meses de tratamento com o aflibercepte intravítreo. Resultados: Satisfizeram aos critérios de inclusão 33 olhos. A mediana da idade dos pacientes foi de 73,57 ± 7,98 anos. Dos pacientes, 21 (61,8%) eram homens e 12 (35,3%) eram mulheres. Antes da transição para o tratamento com o aflibercepte intravítreo, os pacientes receberam em média 16,8 ± 8,8 injeções de ranibizumabe (faixa 6-38).Depois da transição, o número médio de injeções de aflibercepte foi de 9,09 ± 3,94. Não houve diferenças significativas na melhor acuidade visual corrigida depois da mudança para o aflibercepte em qualquer das avaliações. Houve diminuição significativa da espessura macular central aos 6, 12, 18 e 30 meses (respectivamente, p=0,01, p=0,03, p=0,05, p=0,05 e p<0,001). Conclusão: Pacientes com degeneração macular neovascular relacionada à idade que mudaram seu tratamento para o aflibercepte intravítreo devido à falta de resposta ao ranibizumabe intravítreo, tiveram melhora anatômica significativa da retina; mas embora esse estado tenha persistido, não foi observado nenhum ganho funcional significativo.

ABSTRACT Purpose: This study was conducted to evaluate visual function and changes in the central macular thickness of patients with unresponsive neovascular age-related macular degeneration who were switched from ranibizumab (Lucentis®) to aflibercept (Eylea®) treatment at 30 months. Methods: This retrospective study examined patients with neovascular age-related macular degeneration who were switched to aflibercept after ≥6 previous intravitreal ranibizumab injections at 4- to 8-week intervals. All patients were switched to intravitreal aflibercept (2.0 mg) and analyzed after 3 consecutive injections followed by a prore nata dosing regimen and after 30 months of treatment. Best corrected visual acuity, biomicroscopic examination, intraocular pressure, fundus examination, and central macular thickness were recorded at the start of treatment, before the transition to intravitreal aflibercept treatment, and at 6, 12, 18, 24, and 30 months of intravitreal aflibercept treatment. Results: A total of 33 eyes met the inclusion criteria. The median age of the patients was 73.57 ± 7.98 years, and 21 (61.8%) patients were males and 12 (35.3%) were females. Before the transition, the patients received a mean of 16.8 ± 8.8 ranibizumab injections (range 6-38).After the transition to intravitreal aflibercept treatment, the mean number of aflibercept injections was 9.09 ± 3.94. No significant differences were observed in best corrected visual acuity after the aflibercept switch in any of the months. The central macular thickness was significantly decreased at 6, 12, 18, and 30 months (p=0.01, p=0.03, p=0.05, p=0.05, p<0.001, respectively). Conclusion: Patients with neovascular age-related macular degeneration who were switched to intravitreal aflibercept treatment due to unresponsiveness to intravitreal ranibizumab exhibited a significant anatomic improvement in the retina, and although this state persisted, there was no significant functional gain.

RESUMO Objetivo: Comparar as respostas de dor de pacientes com retinopatia diabética proliferativa (PDR) submetidos à panfotocoagulação retiniana (PRP) usando laser de padrão de varredura (PASCAL) ou fotocoagulação navegada a laser (NAVILAS). Métodos: Pacientes com diagnóstico de PDR foram aleatoriamente designados para submeter-se ao tratamento de fotocoagulação com PASCAL ou NAVILAS. A PRP foi realizada no modo "multi-shot" com diâmetro do laser de 200-400 µm e duração do pulso de 30 ms, utilizados para se obter uma mancha branca-acinzentada na retina. Os parâmetros foram idênticos em ambos os procedimentos. Após 30 minutos da PRP, os pacientes foram solicitados a descrever verbalmente a sua percepção da dor como quer "nenhuma," "leve," "moderada," "intensa" ou "dor muito intensa" por meio de uma escala de avaliação verbal (VRS) e também por meio de uma escala visual analógica (VAS), indicando uma pontuação de "0" a "10" representando a intensidade da dor de "nenhuma dor" a "dor intensa." Resultados: Um total de 60 olhos de 60 pacientes (20 mulheres e 40 homens) com diagnóstico de PDR foram tratados. A média de idade dos pacientes foi de 62,22 ± 9,19 anos e a média de duração da diabete foi 195.47 ± 94,54 meses. O número médio de pulsos de laser emitidos durante a PRP foi 389,47 ± 71,52 no grupo NAVILAS e 392,70 ± 54,33 no grupo PASCAL (p=0,57). A diferença nas respostas de dor entre os pacientes nos grupos NAVILAS e PASCAL foi significativa em relação às médias de VRS (1,10 ± 0,67 e 1,47 ± 0,69; p=0,042) e VAS (2,13 ± 1,17 e 2,97 ± 1,35; p=0,034). Conclusões: As respostas de dor em pacientes submetidos à PRP com pulsos de 30 ms de duração foram significativamente menores nos pacientes do grupo NAVILAS em relação ao grupo PASCAL.

ABSTRACT Purpose: To compare the pain responses of patients with proliferative diabetic retinopathy (PDR) undergoing panretinal photocoagulation (PRP) using either pattern scan laser (PASCAL) or navigated laser photocoagulation (NAVILAS). Methods: Patients diagnosed with PDR were randomly assigned to undergo either PASCAL or NAVILAS photocoagulation treatment. PRP was performed using the multi-shot mode with a spot size of 200-400 µm and a pulse duration of 30 ms to obtain a white-grayish spot on the retina. Parameters were identical in both procedures. After 30 min of PRP application, patients were asked to verbally describe their pain perception as either "none," "mild," "moderate," "severe," or "very severe" using a verbal rating scale (VRS) and visual analog scale (VAS) by indicating a score from "0" to "10," representing the severity of pain from "no pain" to "severe pain." Results: A total of 60 eyes of 60 patients (20 females and 40 males) diagnosed with PDR were treated. The mean age of patients was 62.22 ± 9.19 years, and the mean diabetes duration was 195.47 ± 94.54 months. The mean number of laser spots delivered during PRP was 389.47 ± 71.52 in the NAVILAS group and 392.70 ± 54.33 in the PASCAL group (p=0.57). The difference in pain responses between patients in the NAVILAS and PASCAL groups was significant with regard to the mean VRS (1.10 ± 0.67 and 1.47 ± 0.69, respectively; p=0.042) and mean VAS (2.13 ± 1.17 and 2.97 ± 1.35, respectively; p=0.034) scores. Conclusions: Pain responses in patients undergoing PRP with a 30-ms pulse duration were significantly milder in the NAVILAS group than in the PASCAL group.

RESUMO Uma mulher de 27 anos apresentou-se com uma história de longa data de deficiência visual em ambos os olhos. O exame oftalmológico após dilatação pupilar revelou coloboma de cristalino bilateral localizado no quadrante temporal inferior. Nenhuma outra alteração ocular associadas foi observada, exceto ambliopia. A valva aórtica bicúspide foi diagnosticada no exame de ecocardiograma durante a avaliação sistêmica. Coloboma cristaliniano ocorre geralmente de forma unilateral, no entanto já foi descrito bilateralmente, associado a outras malformações oculares ou isolado. Esta é a primeira descrição de coloboma cristaliniano isolado bilateral associado à valva aórtica bicúspide. Embora a associação de valva aórtica bicúspide e coloboma cristaliniano no nosso caso pode ter sido um achado incidental, eles podem ser componentes de uma síndrome desconhecida.

ABSTRACT A 27-year-old woman presented with a history of long-standing poor vision in both eyes. Ophthalmologic examination after pupillary dilatation revealed bilateral lens coloboma situated in the inferotemporal quadrant. No associated ocular abnormalities were seen, except amblyopia. A bicuspid aortic valve was observed during echocardiography during systemic evaluation. Lens coloboma usually occurs unilaterally; however, bilateral lens coloboma which is isolated or associated with other ocular malformations is also encountered. This is the first description of bilateral isolated lenticular coloboma associated with bicuspid aortic valve. Although the association between bicuspid aortic valve and lens coloboma may be an incidental finding, they may be components of an unknown syndrome.

OBJETIVOS: Durante o tratamento de fraturas fechadas do colo do metacarpo do dedo mínimo (fraturas do boxeador) usando fixação percutânea com fio K transversal e outros procedimentos, pode ocorrer lesão iatrogênica do ramo digital dorsal do dedo mínimo (RDDDM) do ramo dorsal do nervo ulnar (RDNU). Neste estudo, visamos descrever a relação do RDDDM do RDNU e os pontos de inserção na face lateral do quinto metacarpo durante fixação percutânea com fio K transversal de fraturas subcapitais. MÉTODOS: Foram realizadas dissecações e medições desse ramo depois de colocação de pino transversal percutâneo na parte distal do quinto osso do metacarpo em dez mãos de cadáveres fixadas em formalina. RESULTADOS: Os resultados desse estudo confirmam a grande proximidade da trajetória do pino e desse ramo, e demonstram sua possível lesão iatrogênica durante a fixação do fio K no quinto metacarpo. CONCLUSÕES: Para evitar a penetração desse nervo e limitar as chances de lesão iatrogênica, é importante conhecer o trajeto desse nervo. Os autores descrevem os pontos de inserção anatômica e acreditam que com uso do conhecimento da anatomia das fraturas subcapitais do quinto metacarpo, elas podem ser tratadas sem risco de déficits sensoriais futuros.

OBJECTIVES: When treating closed fractures of the neck of the little finger metacarpal (boxer fractures) with percutaneous transverse K-wire fixation and other procedures, there may be iatrogenic injury to the dorsal digital branch to the little finger (DDBLF) of the dorsal branch of the ulnar nerve (DBUN . In this study we aimed to describe the relationship of the DDBLF of the DBUN and the insertion points on the external side of the fifth metacarpal during percutaneous transverse K-wire fixation of subcapital fractures. METHODS: Dissections and measurements regarding this branch were performed after percutaneous transverse pinning to distal part of fifth metacarpal bones in ten cadaver hands formalin fixed. RESULTS: The results of this study confirm the close proximity of the trajectory of the with this branch and demonstrate its potential iatrogenic injury during K-wire fixation of the fifth metacarpal. CONCLUSIONS: To avoid penetration of this nerve and limit the chances of iatrogenic injury it is important to know its course. The authors describe the anatomical insertion points and believe that using the anatomical knowledge, subcapital fifth metacarpal fractures can be treated without risk of sensory deficits.