ABSTRACT
Chiasmal syndromes present mostly with visual problems, such as changes in visual fields, decreased visual acuity, or dyschromatopsia (and classically without pupillary reflex defects). The prototypical bitemporal hemianopia upon visual field testing can easily suggest chiasmal compression due to sellar/suprasellar involvement. However, because of the complexity of the decussation of fibres at the optic chiasm and the presence of anatomical variants, unpredictable visual fields defects can be detected in chiasmal diseases. In some patients, especially in those who have undergone neurosurgical procedures, visual field examination and neuroimaging may not completely reflect the classical pattern of chiasmal visual loss. We describe a novel semiological sign, reporting a patient in which a pupillary bitemporal hemihypokinesia was not accompanied by hemianopia, with the phenomenon being abolished by surgical resection of the causative pituitary macroadenoma. In addition, this finding was an important tool in making the diagnosis.
ABSTRACT
INTRODUCTION: The flu, a condition that can affect the elderly by increasing the risk of serious complications can be prevented through vaccination. Estimate the prevalence of signs and symptoms suggestive of influenza in a group of elderly either vaccinated or unvaccinated against influenza was the objective this study. METHODS: This is a cross-sectional study performed in a Brazilian City. A structured questionnaire was employed to identify the presence of signs and symptoms of influenza in individuals aged 60 years or over. For analysis of associations between variables the prevalence ratio (PR) and its 95% confidence interval (95% CI) were used. RESULTS: One hundred ninety-six participants were interviewed, of whom 57.7% were female. The average age was 69.7 years. About 25% of the vaccinated and 20% of the unvaccinated in 2009, and 25% of the vaccinated and 22.5% of the unvaccinated in 2010 reported having the flu. Among the vaccinated and unvaccinated in 2009 and 2010, there was no verified association between vaccination and influenza (PR=1.24; [95% CI: 0.63-2.43] and PR=1.11; [95% CI: 0.59-2.09], respectively). CONCLUSIONS: This study suggests that, among the elderly selected, the vaccination coverage for influenza is below the ideal, even with projection of the best indices for 2011 (~ 84%). The data on vaccination and disease protection needs further research; however, the results point to the need for measures to better clarify to this population about the disease, its complications and the benefits of vaccination, in addition to combatting the stigma related to low adherence.
INTRODUÇÃO: A gripe, condição que pode afetar a saúde dos idosos aumentando o risco de complicações graves pode ser prevenida por meio de vacina. O objetivo deste estudo foi estimar a prevalência de sinais e sintomas sugestivos de gripe em um grupo de idosos vacinados e não vacinados contra influenza. MÉTODOS: Estudo transversal realizado em uma cidade brasileira. Usou-se questionário estruturado para identificar presença de sinais e sintomas de gripe em indivíduos com idade igual ou maior de 60 anos. Para análise de associação entre variáveis empregou-se a razão de prevalência e seu intervalo de confiança a 95%. RESULTADOS: Dos 196 participantes, 57,7% eram do sexo feminino e a média de idade foi 69,7 anos. Aproximadamente, 25% dos vacinados e 20% dos não vacinados em 2009 e 25% dos vacinados e 22,5% dos não vacinados em 2010, relataram sinais e sintomas de gripe. Entre os vacinados e não vacinados, em 2009 e 2010, não foi verificada associação entre vacinação e gripe (RP = 1,24; [IC 95%: 0,63-2,43] e RP = 1,11; [IC95%: 0,59-2,09]), respectivamente). CONCLUSÕES: O estudo sugere que, entre os idosos estudados, a cobertura vacinal para a gripe encontra-se abaixo do ideal, com projeção de melhores índices para 2011 (± 84%). Os dados sobre a vacinação e proteção contra a doença carece de novas pesquisas, entretanto, os resultados apontam para necessidade de medidas para esclarecer melhor a população sobre a doença, suas complicações e benefícios da vacinação, além de combater estigmas relacionados à baixa adesão.
Subject(s)
Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Influenza Vaccines/therapeutic use , Influenza, Human/prevention & control , Patient Compliance/statistics & numerical data , Brazil/epidemiology , Cross-Sectional Studies , Influenza, Human/epidemiology , Socioeconomic Factors , Surveys and QuestionnairesABSTRACT
INTRODUCTION: The flu, a condition that can affect the elderly by increasing the risk of serious complications can be prevented through vaccination. Estimate the prevalence of signs and symptoms suggestive of influenza in a group of elderly either vaccinated or unvaccinated against influenza was the objective this study. METHODS: This is a cross-sectional study performed in a Brazilian City. A structured questionnaire was employed to identify the presence of signs and symptoms of influenza in individuals aged 60 years or over. For analysis of associations between variables the prevalence ratio (PR) and its 95% confidence interval (95% CI) were used. RESULTS: One hundred ninety-six participants were interviewed, of whom 57.7% were female. The average age was 69.7 years. About 25% of the vaccinated and 20% of the unvaccinated in 2009, and 25% of the vaccinated and 22.5% of the unvaccinated in 2010 reported having the flu. Among the vaccinated and unvaccinated in 2009 and 2010, there was no verified association between vaccination and influenza (PR=1.24; [95% CI: 0.63-2.43] and PR=1.11; [95% CI: 0.59-2.09], respectively). CONCLUSIONS: This study suggests that, among the elderly selected, the vaccination coverage for influenza is below the ideal, even with projection of the best indices for 2011 (~ 84%). The data on vaccination and disease protection needs further research; however, the results point to the need for measures to better clarify to this population about the disease, its complications and the benefits of vaccination, in addition to combatting the stigma related to low adherence.
