Multiple layers on the Descemet membrane

Abstract

Relato de caso não descrito na literatura oftalmológica nacional de múltiplas camadas da membrana de Descemet. Mulher de 59 anos, pseudofácica, com diagnóstico de ceratopatia bolhosa, foi submetida à ceratoplastia penetrante em olho direito, sendo encontrado achado incomum de multiplicidade de camadas da membrana de Descemet, variáveis em forma e espessura, além de corpos ovoides com coloração de metamina de prata de Gocott-Gomori (GMS) negativa. Como a membrana de Descemet tem no seu desenvolvimento um período fetal e outro pós-natal que frequentemente é bem identificável nos cortes histológicos em adultos. No caso apresentado, em que outras camadas estão presentes, há evidência de corpos esféricos que poderiam significar que a potencialidade de produzir outras camadas pode permanecer na fase adulta mais tardia.

Neonatal hypoglycemia in dogs—pathophysiology, risk factors, diagnosis and treatment

“…Hypoglycemia is the most common metabolic alteration in newborn patients. In veterinary medicine, the puppies most likely to manifest hypoglycemia are neonates who have gone through stressful events such as hypoxia at birth, neonates born from hypoglycemic mothers, sick, orphaned, premature and low birth weight neonates (5,29,41). Table 1 shows the main risk factors for the development of neonatal hypoglycemia.…”

“…In addition, systemic infections, such as neonatal sepsis, lead to rapid glucose consumption and increased risk of hypoglycemia (1,4,5,9,43,44). A study demonstrated that approximately 65% of neonates in sepsis develop hypoglycemia (41).…”

“…Severe hypoglycemia can lead to bradycardia, cyanosis, seizures, coma and death (6,25,40,41,52). Bradycardia occurs due to reduced metabolism and glucose supply to the myocardium.…”

“…Bradycardia occurs due to reduced metabolism and glucose supply to the myocardium. As the treatment is carried out and the blood glucose increases, the heart rate increases concomitantly (41,53). Seizures and coma are consequences of encephalopathy caused by severe hypoglycemia.…”

“…In older studies, lower concentrations, such as 40 mg/dL, were considered normal (25). However, a recent study demonstrated a mean glycemic level of 125 mg/dL (range 106-182 mg/ dL) in 349 healthy neonatal dogs during the first four weeks of age (41). As a glucose concentration < 92 mg/dL during the first 24 h of life is correlated with a higher risk of death during the first 21 days of age (4), it is understood that concentrations lower than this are no longer considered normal.…”