ABSTRACT
RESUMO Objetivo Avaliar os mapeamentos de retina realizados em interconsultas oftalmológicas, analisando as prevalências de alterações encontradas e comparando-as com o motivo da interconsulta. Métodos Estudo transversal, com dados encontrados durante exame de mapeamento de retina de pacientes internados ou em atendimento no pronto-socorro. Os dados analisados de cada paciente foram idade, sexo, especialidade médica solicitante, motivo da interconsulta e achados do exame fundoscópico. Resultados Foram avaliados 104 pacientes, com prevalência de alterações ao exame em 43,27%. Os motivos mais frequentes de solicitação de avaliação oftalmológica foram trauma (16,35%) e alterações neurológicas (15,38%). O achado com maior prevalência foi o edema de papila, presente em 17,3% das avaliações gerais. Outros achados muito prevalentes foram as retinopatias diabética e hipertensiva, ambas com 11,53% na avaliação geral, mas com 83,3% e 53,84% de prevalência nos pacientes cujos motivos da consulta foram diabetes mellitus descompensada e crise hipertensiva, respectivamente. Conclusão O edema de papila e as retinopatias diabética e hipertensiva foram as alterações mais prevalentes, o que demonstra a importância do atendimento multidisciplinar sempre que possível, com maior atenção aos pacientes hipertensos e diabéticos.
ABSTRACT Objective To evaluate the indirect ophthalmoscopy performed in ophthalmologic consultations, analyzing the prevalence of the study and comparing them with the reason for the consultation. Methods Cross-sectional study, with data found during the indirect ophthalmoscopy exam of inpatients or in emergency room care. The data analyzed for each patient was sex, the requested medical age, the reason for the consultation and the funduscopic examination findings. Results One hundred and four patients were evaluated and 43.27% of patients with a prevalence of changes in the exam. The most requested reasons for requesting ophthalmologic evaluation were trauma (16.35%) and neurological alterations (15.38%). The most prevalent finding was papillary edema, representing 17.3% of the general estimates. Other very prevalent findings were diabetic and hypertensive retinopathies, both with 11.53% in the general assessment, but with 83.3% and 53.84% prevalence in patients whose reasons for consultation were decompensated DM and hypertensive crisis, respectively. Conclusions Papillary edema and diabetic and hypertensive retinopathies were the most prevalent alterations, which demonstrates the importance of multidisciplinary care whenever possible, with greater attention to hypertensive and diabetic patients.
ABSTRACT
Molecular neurobiology has provided an explanation of mechanisms supporting mental functions as learning, memory, emotion and consciousness. However, an explanatory gap remains between two levels of decription: molecular mechanisms determining cellular and tissue functions, and cognitive functions. In this paper we review molecular and cellular mechanisms that determine brain activity, and thenn hypothetize about their relation with cognitition and consciousness. The brain is conceived of as a dynamic system that exchanges information with the whole body and the environment. Three explanatory hypotheses are presented, stating that: a) brain tissue function is coordinated by macromolecules controlling ion movements, b) structured (amplitude, frequency and phase-modulated) local field potentials generated by organized ionic movement embody cognitive information patterns, and c) conscious episodes are constructed by a large-scale mechanism that usesnoscillatory synchrony to integrat local field patterns.