Subject(s)
Humans , Eye Abnormalities , Tomography, Optical Coherence , Anterior Eye Segment , Iris , Follow-Up StudiesABSTRACT
ABSTRACT This report was written to describe a case of unilateral brimonidine-induced conjunctival lichen planus. Because the ophthalmic examination indicated chronic conjunctivitis or drug-induced pseudopemphigoid, the patient underwent thorough ophthalmic and systemic examinations, as well as conjunctival biopsy and direct immunofluorescence studies. A 71-year-old woman with unilateral left eye findings of chronic conjunctivitis was referred to our Ophthalmology Department. The patient reported that chronic conjunctivitis began shortly after she initiated use of topical brimonidine. Ophthalmic examination revealed foreshortening of the inferior fornix and symblepharon. Conjunctival biopsy revealed submucous lymphocytes and shaggy distribution of fibrinogen on direct immunofluorescence; this was suggestive of ocular lichen planus. No other systemic lesions were found that were consistent with the presentation of lichen planus. A good response was observed to topical cyclosporine treatment. To our knowledge, this may be the first report of unilateral ocular lichen planus without systemic findings. The correlation with the initiation of topical brimonidine suggests that this might be the first case of biopsy-confirmed brimonidine-induced ocular lichen planus.
RESUMO Este relato é para descrever um caso de líquen plano conjuntival unilateral induzido por brimonidina. Como o exame oftalmológico indicava conjuntivite crônica ou pseudopenfigóide induzido por medicamento, o paciente foi submetido a exames oftalmológicos e sistémicos completos, além de biópsia conjuntival e estudos de imunofluorescência direta. Uma mulher de 71 anos de idade com achados unilaterais do olho esquerdo de conjuntivite crônica foi encaminhada ao nosso departamento de Oftalmologia. A paciente relatou que a conjuntivite crônica começou logo após o início do uso da brimonidina tópica. O exame oftalmológico revelou encurtamento do fórnice inferior e do symblepharon. A biópsia conjuntival revelou linfócitos submucosos e distribuição felpuda de fibrinogênio na imunofluorescência direta; isso era sugestivo de líquen plano ocular. Não foram encontradas outras lesões sistêmicas compatíveis com a apresentação do líquen plano. Uma boa resposta foi observada no tratamento tópico com ciclosporina. Pelo nosso conhecimento, este pode ser o primeiro relato de líquen plano ocular unilateral sem achados sistêmicos. A correlação com o início da brimonidina tópica sugere que este pode ser o primeiro caso de líquen plano ocular induzido por brimonidina confirmado por biópsia.
Subject(s)
Humans , Female , Aged , Conjunctival Diseases/chemically induced , Brimonidine Tartrate/adverse effects , Lichen Planus/chemically induced , Antihypertensive Agents/adverse effects , Biopsy , Cyclosporine/therapeutic use , Conjunctiva/pathology , Conjunctival Diseases/pathology , Conjunctival Diseases/drug therapy , Immunosuppressive Agents/therapeutic use , Lichen Planus/pathology , Lichen Planus/drug therapyABSTRACT
Las enfermedades no transmisibles representan un problema de salud pública a nivel mundial. Los objetivos de este estudio fueron: determinar la prevalencia de obesidad y la asociación con variables socioeconómicas, antropométricas, composición corporal, actividad física, consumo de alimentos y seguridad alimentaria e identificar riesgo temprano de diabetes tipo 2 (DT2) en niños escolares urbanos. El presente es un estudio transversal, de 1052 niños de escuelas públicas y privadas de ocho ciudades de Venezuela. Las variables obtenidas incluyeron: peso, talla, índice de masa corporal (IMC), porcentaje de grasa corporal (PGC), actividad física y en una sub-muestra glicemia capilar y circunferencia de cintura. Se aplicó una encuesta para determinar estrato socio económico (ESE), actividad física, percepción de seguridad alimentaria y hábitos de estilo de vida. La prevalencia de obesidad fue 26,4 % según IMC y 26,5%, según PGC; el déficit fue de 10,3% según IMC y de 13,5% según PGC. El 40,2% de los niños pertenecían a ESE medios, bajos y muy bajos, en tanto que 48,7% pertenecía al ESE medio alto, según el Método Graffar-Méndez Castellano. En el análisis de correspondencias múltiples se observó una alta contribución al eje factorial de los excesos de grasa corporal, peso e IMC por parte del consumo de comida chatarra, dulces, bebidas azucaradas y proteínas fritas. La ciudad con mayor prevalencia de obesidad de acuerdo con el PGC fue Maracay. El análisis (OR) entre la glicemia y las diferentes variables no fue significativo. Se identificó además la presencia de la doble carga desnutrición y obesidad en la población escolar estudiada(AU)
Non communicable diseases are a major health concern. The aim of this study was to measure obesity prevalence among school age children in 8 cities of Venezuela and the association with sociodemographic, antropometric, physical activity, body composition and food security variables and to identify risk factors for developing type 2 diabetes in the future. This is a cross sectional study of 1052 children recruited in 2011 at public and private schools. Anthropometric variables, body mass index (BMI) and body fat percentage (BFP) were obtained and there was a subsample in Caracas where capillary glucose and waist circumference were performed. A semi-structured questionnaire for evaluating socioeconomic status (SES), perception of food insecurity and lifestyle habits was given to parents of children in order to obtain information. A general prevalence 26.4 % of Obesity according to BMI was reported, whereas by BFP was 26.5%, deficit of BMI was 10.3% and low BFP 13.5%. The city with the highest prevalence of obesity according to BFP was Maracay, Aragua State. The 40.2% of children belonged to medium, low and very low SES, while 48.5% classified as medium high SES according to Graffar-Mendez Castellanos method. A high contribution of excess of fried foods, sweets, sugary beverages and junk foods was found to the axis of high BMI, weight and BFP when Multiple Correspondence Analysis was performed. OR analysis didnt show significance between different variables. There was a consistent finding of the existence of the double burden: obesity-undernutrition as has been shown in other studies(AU)