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ABSTRACT: To determine the association between ocular abnormalities and hematologic findings in Ehrlichia canis-infected dogs, 120 dogs suspected of canine ehrlichiosis were studied. All patients were subjected to rapid serologic diagnostic test for Ehrlichia canis, and the diagnosis was confirmed by quantitative PCR. PCR-positive patients underwent ophthalmologic examination and a hemogram and were grouped into patients with thrombocytopenia and anemia (G1), patients with thrombocytopenia (G2), and patients without hematologic disorders (G3). For ophthalmic evaluation, the patients were grouped into those having mild, severe, both mild and severe, and no ocular alterations. All patients presented with uveitis (100%). Severe ocular disorders predominated in G1 and G2 patients. Dogs with anemia and leukopenia showed severe ocular disorders. In dogs with a greater number of leukocytes and copies/µl of the TRAG gene, the intraocular pressure (IOP) tends to decrease and vice versa (r = −0.23, r = −0.26). In conclusion, uveitis is the earliest ocular alteration of canine ehrlichiosis. The severity of ocular abnormalities in patients with ehrlichiosis is associated with thrombocytopenia and may be aggravated by anemia and leukopenia. The hemogram and IOP are useful tools for predicting eye involvement in Ehrlichia canis-infected patients. In regions where Ehrlichia canis is endemic, the use of the tonometer should be routinely in dog general consultation.
RESUMO: Para determinar a associação entre anormalidades oculares e achados hematológicos em cães infectados com Ehrlichia canis, foram estudados 120 cães com suspeita de erliquiose canina. Todos os pacientes foram submetidos a um teste diagnóstico sorológico rápido para Ehrlichia canis, e o diagnóstico foi confirmado por PCR quantitativa. Os pacientes com PCR positivo foram submetidos a exame oftalmológico e hemograma completo e foram agrupados em pacientes com trombocitopenia e anemia (G1), pacientes com trombocitopenia (G2) e pacientes sem distúrbios hematológicos (G3). Para avaliação oftalmológica, os pacientes foram agrupados em pacientes com alterações leves ou graves, leves e graves e sem anormalidades oculares. Todos os pacientes apresentaram uveíte (100%). Os distúrbios oculares graves predominaram nos pacientes do G1 e G2. Cães com anemia e leucopenia apresentaram distúrbios oculares graves. Em cães com maior número de leucócitos e cópias/µl do gene TRAG, a pressão intra-ocular tendeu a diminuir e vice-versa (r = -0.23, r = -0.26). Em conclusão, a uveíte é o primeiro distúrbio ocular da erliquiose canina. A gravidade das anormalidades oculares em pacientes com erliquiose está associada à trombocitopenia e pode ser agravada por anemia e leucopenia. Hemograma e PIO são ferramentas úteis para prever o envolvimento ocular em pacientes infectados com Ehrlichia canis. Nas regiões em que o Ehrlichia canis é endêmico, o uso do tonômetro deve ser rotineiro nas consultas gerais de cães.
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O tratamento do glaucoma consiste na redução e no controle da PIO, inicialmente realizado com colírios. Algumas intervenções estão disponíveis, como o iStent® e a trabeculopalstia seletiva a laser (SLT). Métodos: Estudo descritivo de uma série de casos. Foram analisados prontuários de pacientes submetidos ao iStent® ou SLT no Hospital de Olhos do Paraná, no ano de 2017 e acompanhados por no mínimo 6 meses. Resultados: Foram incluídos no estudo 37 pacientes com glaucoma primário de ângulo aberto. Destes, 16 implantaram o iStent® e 21 realizaram a SLT; no grupo do iStent®. No período pré-procedimento, o grupo do iStent® utilizava uma média de 1,9 colírio e o grupo da SLT utilizava uma média de 2,0 colírios; no período pós-procedimento, a média do número de colírios utilizados em ambos os grupos passou a ser de 0,8. Conclusão: Tanto iStent® quanto SLT mostram-se como opções viáveis frente ao uso de colírios.
Glaucoma`s treatment is the reduction and control of IOP and is initially done with eye drops. Some of the alternative treatments available are iStent® or SLT. Methods: Descriptive study of a case series. Medical records from patients with iStent® or SLT at the Hospital de Olhos do Paraná, in 2017, were analyzed and followed up for a least 6 months. Results: The study included 37 patients with primary open angle glaucoma. Of these, 16 had the iStent® implanted and 21 had the SLT performed on their eyes. The average number of eye drop medications that the patients were using was 1,9 and 2,0, in the iStent® and SLT groups, respectively; while in the postoperative period the average was 0,8 and 0,8. Conclusion: iStent® and SLT are capable options when confronted against eye drops.
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Introduction: The Right to Information Act 2005 is asignificant development in Indian Democratic fabric. ItProvides a platform for Citizens where they have the right togain access to information which is under Public authority. Theaccess to information under the RTI act 2005 includes a rightto obtain Personal medical information generated within thehospitals and their research projects. The citizens are utilizingthe tool of RTI in health care services which has resulted inimproved care and better management of health centers. ThePresent study was conducted in 794 bedded tertiary careteaching hospital with an aim to find out the profile and patternof applications received through RTI act protocol.Material and Methods: This hospital record basedprospective observational study was carried out in Sherikashmir institute of medical sciences (SKIMS), a tertiary carehospital from October 2016 to February 2018. All the RTIapplications received during the study period were selectedfor the study. The data was collected by an investigator afterscrutiny of received applications and was verified from thedesignated PIO.Results: Among 119 applications, 115 cases (96.6%) weresolved by providing required information Among 115 resolvedRTI applications, majority i.e 47(40.8%) of cases wereresolved between 15-30 days, the process of 46 (40%) RTIapplications was expedited by issuing only one (1) reminderto concerned quarters, 105 cases were concluded at PIO levelwhile 10 applicants appealed to First appellant authority (FAA)which happened to be the Medical superintendent of Hospital,most of the applications were for Policy and Personal section(50, 42.01%), most common subject matter was informationregarding a Hospital staff member (21, 17.64%) and amongthe queries, most were information inquiry (83%, 69.74%).Conclusions: Healthcare personnel must acquire, process,store, retrieve and transfer clinical, administrative andfinancial health information. Privacy and confidentiality areimportant issues and their protection in the fiduciary doctorpatient relationship encourages citizens to seek necessarymedical care and disclosure of information is vital if largerpublic interest is involved.
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INTRODUCCIÓN: las infecciones respiratorias agudas, sobre todo las neumonías, son uno de los principales problemas de salud en los niños menores de 5 años de edad en los países en desarrollo. OBJETIVO: caracterizar la neumonía grave adquirida en la comunidad en el servicio de Neumología. MÉTODOS: se realizó un trabajo prospectivo descriptivo, de corte transversal. Se seleccionaron los pacientes que ingresaron en el servicio de Neumología, con una neumonía grave adquirida en la comunidad, procedentes de la Unidad de Terapia Intensiva o del Cuerpo de Guardia, desde diciembre de 2005 a diciembre de 2010. Se incluyeron 187 pacientes con aparente salud anterior, seguidos por consulta al egreso hasta su alta médica. Se practicó un análisis descriptivo de las variables clínicas, radiológicas y de tratamiento. RESULTADOS: de 187 pacientes el 76,4 % eran menores de 5 años, y el 53,5 % femeninos. El factor de riesgo más frecuente fue la no lactancia materna exclusiva (91,6 %) en el grupo de edad de 1-4 años. La fiebre, la polipnea y el tiraje estuvieron presentes en la mayoría de ellos. El pulmón derecho fue el más afectado en el 57,7 %, pero se registró mayor cifra de complicaciones en el izquierdo (58,2%). Las complicaciones más frecuentes fueron: el derrame pleural y el absceso pulmonar en 40,6 y 10,2 %, respectivamente. El tratamiento con penicilina cristalina sola se usó en el 36,3 % de los pacientes, y se logró una buena evolución clínica, sin hacer cambios terapéuticos. CONCLUSIONES: los pacientes en su totalidad evolucionan de forma favorable con los esquemas de antibióticos utilizados.
INTRODUCTION: acute respiratory infections, mainly pneumonias, are the main health problems in children aged under 5 years in developing countries. OBJECTIVE: to characterize the community-acquired severe pneumonia in the pneumonia management service. METHODS: a prospective, descriptive and cross-sectional study was conducted. There were selected those patients who were admitted to the pneumonia management service with community-acquired severe pneumonia and had been referred from the intensive care unit or the emergency service in the period of December 2005 to December 2010. One hundred and eighty seven patients in apparent healthy condition before the disease, who had been followed-up from the time of discharge from the hospital until their final medical discharge, were included in the research. A descriptive analysis of the clinical, radiological and therapeutic variables was made. RESULTS: of 187 patients, 76.4 % were aged under 5 years, 53.5 % were females. The most common risk factor was non-exclusive breastfeeding (91.6 %) in the 1-4 year age group. Fever, polypnea and tirage were present in most of them. The right lung was the most affected in 57.7 % of cases, but the left lung provided the highest number of complications (58.2 %). The most common complications were pleural effusion and the pulmonary abscess in 40.6 % and 10.2 %, respectively. The single crystalline penicillin treatment was used in 36.7 % of patients with good clinical progression with no further therapeutic changes. CONCLUSIONS: all the patients has favorable recovery with the antibiotic treatments used.