Long-term outcomes of therapeutic corneal transplants performed in a tertiary eye care hospital in South India

Purpose: This study aimed to review the demographics, clinical characteristics, and long?term outcomes of therapeutic penetrating keratoplasty (TPK) performed in a tertiary eye care hospital. Methods: Case records of 149 therapeutic transplants (135 patients) that were performed during the calendar year 2016 were retrospectively analyzed, and outcomes were measured until 3 years of follow?up. Information on demographics, presentation characteristics, keratoplasty indications, offending microbe, and secondary surgical interventions was studied. The final outcome was classified in terms of therapeutic, anatomical, and functional outcomes. Results: The median age of the recipients was 55 years with 61% men. The most common indications for TPK were perforated infectious ulcer (45.9%), nonhealing ulcers (29.9%), and graft infections (17.4%). Fungal etiology was noted in 61.2% and bacterial etiology in 17.4% of the eyes. Therapeutic success was achieved in 130 eyes (89%) at the end of 1 month. Anatomical success was achieved in 130 (98.5%) and 88 patients (86.3%) at the end of 1 and 6 months, respectively. At the 6?month time point, 78 patients (76.5%) attained functional success with vision better than light perception. Three?year follow?up data were available for 23.7% of recipients, of which only 12 patients (37.5%) retained a clear graft either after a primary therapeutic or secondary optical keratoplasty. Conclusion: Therapeutic keratoplasty is highly effective in eradicating infection and providing anatomical integrity. However, timely intervention can aid in achieving the best functional outcome.

Caracterização dos estudos sobre ambivalência em Psicoterapia: uma revisão de literatura / Characterization of ambivalence studies in Psychotherapy: a literature review

Em psicoterapia, a ambivalência é definida como posições opostas, do paciente, em relação à mudança e tem sido apontada como uma variável de forte interferência nos resultados terapêuticos. Devido à importância e influência desse fenômeno para o desenvolvimento e resultado da terapia, e à escassez de pesquisas que tenham essa temática como objeto de estudo, objetiva-se apresentar uma revisão de literatura englobando artigos que definam a ambivalência, apresentem sua relação com o sucesso terapêutico, avaliem instrumentos e abordem teorias que embasam o fenômeno. Foram utilizados os descritores "Ambivalence", "Psychotherapy" e "Motivation for change" nas bases de dados PubMed, PsychoINFO e Web of Science. Inicialmente foram encontrados 2178 artigos, dos quais 13 foram incluídos por preencherem os seguintes critérios: estudos em português, inglês ou espanhol, que tinham como objetivo principal relacionar a ambivalência com resultados terapêuticos, definir a ambivalência, avaliar instrumentos de identificação e mensuração da ambivalência ou apresentar a ambivalência a partir de alguma teoria. Os critérios de exclusão foram: teses, dissertações, livros e capítulos de livros, ou estudos realizados há mais de 10 anos. Através dessa revisão de literatura, a Entrevista Motivacional e a teoria dos Momentos de Inovação se apresentaram como principais bases teóricas do fenômeno e diversos estudos evidenciaram a relação da ambivalência com o sucesso terapêutico, indicando a necessidade de que as pesquisas futuras apliquem esforços na construção de melhores definições para esse constructo, no aprofundamento em suas bases teóricas, e principalmente na construção e avaliação de formas de mensuração da ambivalência no contexto da psicoterapia.(AU)

In psychotherapy, ambivalence is defined as the patient's opposite positions in relation to change and has been pointed as a variable of strong interference in therapeutic outcomes. Due to the importance and influence of this phenomenon for the development and outome of the therapy, and the scarcity of research that have this theme as object of study, we aim to present a literature review encompassing articles that define ambivalence, present their relationship with therapeutic success, assess the instruments and address theories underlying the phenomenon. The descriptors "Ambivalence", "Psychotherapy" and "Motivation for change" were used in the PubMed, PsychoINFO and Web of Science databases. Initially, 2178 articles were found, of which 13 were included because they met the following criteria: studies in Portuguese, English or Spanish, whose main objective was to relate ambivalence to therapeutic outcomes, define ambivalence, evaluate instruments for identification and measurement of ambivalence or present ambivalence from some theory. Exclusion criteria were: theses, dissertations, books and book chapters, or studies conducted more than 10 years ago. Through this literature review, the Motivational Interview and the Moments of Innovation theory werepresented as the main theoretical basis of the phenomenon and several studies have shown the relation between ambivalence and therapeutic success, indicating the need for future research to apply efforts in the construction of better definitions for this construct, deepening its theoretical bases, and especially in the construction and evaluation of ways of measuring ambivalence in the context of psychotherapy.(AU)

En psicoterapia, la ambivalencia se define como las posiciones opuestas del paciente en relación con el cambio y se ha señalado como una variable de fuerte interferencia en los resultados terapéuticos. Debido a la importancia e influencia de ese fenómeno para el desarrollo y resultado de la terapia, y la escasez de investigaciones que tienen este tema como objeto de estudio, nuestro objetivo es presentar una revisión de literatura que engloba artículos que definan la ambivalencia, presenten su relación con el éxito terapéutico, evalúen instrumentos y aborden teorías que fundamentan el fenómeno. Se utilizaron los descriptores "Ambivalence", "Psychotherapy" y "Motivation for change" en las bases de datos PubMed, PsychoINFO y Web of Science. Inicialmente, se encontraron 2178 artículos, de los cuales 13 se incluyeron porque cumplían con los siguientes criterios: estudios en portugués, inglés o español, cuyo objetivo principal era relacionar la ambivalencia con los resultados terapéuticos, definir la ambivalencia, evaluar los instrumentos para la identificación y medición de la ambivalencia o la ambivalencia actual de algunos teoría Los criterios de exclusión fueron: tesis, disertaciones, libros y capítulos de libros, o estudios realizados hace más de 10 años. A través de esta revisión de literatura, la Entrevista Motivacional y la teoría de los Momentos de Innovación se presentaron como principales bases teóricas del fenómeno y diversos estudios evidenciaron la relación de la ambivalencia con el éxito terapéutico, indicando la necesidad de que las investigaciones futuras apliquen esfuerzos en la construcción de las mejores definiciones para ese constructo, en la profundización en sus bases teóricas, y principalmente en la construcción y evaluación de formas de medición de la ambivalencia en el contexto de la psicoterapia.(AU)

Plant essential oils against bacteria isolated from fish: an in vitro screening and in vivo efficacy of Lippia origanoides / Óleos essenciais de plantas contra bactérias isoladas de peixes: uma triagem in vitro e eficácia in vivo de Lippia origanoides

ABSTRACT: The use of natural products, such as essential oils (EOs), is a potential novel approach to treat fish bacterial infections with a lower risk of developing resistance. There has been a number of studies reporting the activity of EOs as those obtained from the species Achyrocline satureioides, Aniba parviflora, Aniba rosaeodora, Anthemis nobilis, Conobea scoparioides, Cupressus sempervirens, Illicium verum, Lippia origanoides, and Melaleuca alternifolia against bacteria. However, there are few studies investigating the effect of these EOs against fish bacteria. Therefore, the aim of this study was to evaluate the in vitro antibacterial activity of EOs against the following fish bacteria, Aeromonas hydrophila, Citrobacter freundii, and Raoultella ornithinolytica. Additionally, the in vivo antibacterial activity of the EO L. origanoides was evaluated against experimentally induced A. hydrophila infection of silver catfish (Rhamdia quelen). The EO of L. origanoides was chosen as it showed the highest in vitro antibacterial activity, with minimum inhibitory concentrations ranging from 0.2 to 0.8 mg mL-1. This EO also presented a therapeutic success of 58.33%, on a 30 day A. hydrophila infection. Therefore, we suggested that the EO of L. origanoides may be a viable alternative as a treatment for A. hydrophila infection.

RESUMO: O uso de produtos naturais, como óleos essenciais (OEs), é uma nova abordagem potencial para o tratamento de infecções bacterianas em peixes com um baixo risco de desenvolvimento de resistência. Existem estudos reportando a atividade de OEs como aqueles obtidos das espécies Achyrocline satureioides, Aniba parviflora, Aniba rosaeodora, Anthemis nobilis, Conobea scoparioides, Cupressus sempervirens, Illicium verum, Lippia origanoides e Melaleuca alternifolia contra bactérias. Porém, existem poucos estudos investigando o efeito desses OEs supracitados contra bactérias isoladas de peixes. Portanto, o objetivo desse estudo foi avaliar a atividade antibacteriana in vitro desses OEs contra bactérias isoladas de peixes (Aeromonas hydrophila, Citrobacter freundii e Raoultella ornithinolytica). Assim como avaliar a atividade antibacteriana in vivo do OE de L. origanoides contra uma infecção por A. hydrophila experimentalmente induzida em jundiá (Rhamdia quelen). O OE de L. origanoides foi escolhido porque apresentou a melhor atividade antibacteriana in vitro, com concentrações inibitórias mínimas variando de 0,2 a 0,8 mg mL-1. Esse OE apresentou sucesso terapêutico de 58,33% no dia 30 pós-infecção. Portanto, sugerimos que o OE de L. origanoides possa ser uma alternativa viável no tratamento da infecção por A. hydrophila em peixes.

Look-alike and Sound-alike Drug Brand Names: A Potential Risk in Clinical Practice.

Objective: India’s pharmaceutical industry is now the third largest in the world in terms of volume. With this growth, various drugs with catchy brand names have been introduced. The potential for error due to confusing drug names amongst the healthcare personnel is significant. Numerous case reports and studies have thrown light on the confusion over similar drug names. Despite these efforts, new names that are similar to the existing names continue to be approved. Aim: The study was carried out to isolate confusing brand names, which are used currently in the Indian market and to categorize these names depending on their effect on therapeutic success. Material and methods: Recent issue of the drug formulary Indian Drug Review (IDR) (Vol. XVII Issue No. 2, March-April 2011) was referred to and all the potentially confusing brand names were analyzed. Results: Many of the brand names were similar looking (orthographic) and similar sounding (phonetic). Certain observations regarding brand naming techniques and their possible implications were noted. Conclusion: The Indian pharmaceutical industry is growing at a fast pace. Hence, India needs a competent Medication Error Reporting Program to report the brand name confusion. Also, we need to create more awareness about confusing brand names and their implications.

Clínica psicológica: o manejo do setting e o potencial criativo / Psychologycal clinic: the handling of setting and the creative construction

O trabalho psicológico na clínica pode ser discutido em sua qualidade criativa, enquanto processo de mudanças do ponto de vista da criatividade do paciente, que modifica percepções, sentimentos, pensamentos e comportamentos e do ponto de vista do profissional, que contribui enormemente com o processo clínico. A mudança psíquica é, em tese, um processo criativo, que se ancora no vínculo terapêutico e explica os resultados de sucesso terapêutico. Discutir o processo da mudança psíquica sob o olhar da atuação do psicólogo em suas atividades rotineiras de articular teoria e técnica, escolha de estratégicas para apresentar as interpretações da psicodinâmica do paciente, facilitar percepções ou promover reflexões acerca de dificuldades emocionais, configura-se uma área interessante de estudo já que permite a compreensão das desejáveis mudanças terapêuticas. O manejo do setting neste prisma de entendimento, pode definir-se como relevante objeto de estudo para uma ampliação do conhecimento do potencial criativo na clínica psicológica.

The psychological work in a clinic can be discussed in terms of its creative quality, while process of changes from the point of view of the patient's creativity, that changes perceptions, feelings, thoughts and behaviors, and from the psychologist's point of view, that greatly contributes to the clinical process. The psychic change is, in theory, a creative process, based on the therapeutic bond and explains the results of the therapeutic success. The discussion of the psychic change process from the perspective of the psychologist in his routine activities of articulating theory and practice, the choice of strategies to present the interpretations of the patient's psychodynamics, to facilitate perceptions or to promote reflections on ways of dealing with emotional difficulties, configure an interesting area of study, as it permits the comprehension of the desirable therapeutic changes. The handling of setting from this angle of understanding can be defined as a relevant object of study for the expansion of knowledge of the creative potential in psychological clinic.