Topical Ophthalmic Anesthetic Use for Sterile Corneal Abrasion in the Emergency Department.

OBJECTIVES: Investigate current treatment and prescription practices of topical ophthalmic anesthetic agents (TOAAs) in emergency departments (EDs) across the United States to understand how these encounters may affect ocular health. METHODS: A six question survey regarding the use of topical ophthalmic anesthetics was completed by 73 emergency medicine (EM) physicians across 34 states through the American College of Emergency Physicians (ACEP) Emergency Medicine Practices Research Network (EMPRN). RESULTS: The survey was completed by 73 EM physicians. The majority indicated treating eye-related complaints frequently and comfort using (TOAAs) for pain control in sterile corneal abrasion. Over half of respondents indicated never discharging a patient from the ED with a prescription for TOAAs. The consensus for patient instructions included offering a short course (<48 hr) of treatment. Furthermore, 96% of respondents indicated that they would not prescribe refills for TOAAs, mostly due to concern regarding corneal damage. CONCLUSIONS: Despite demonstrable concern regarding the use of TOAAs and risk of corneal damage, a minority of EM physicians continue to prescribe these agents in the treatment of sterile corneal abrasion, which poses risks to visual health. Ophthalmologists have begun to advocate for decreased availability of TOAAs in settings such as the ED.

Herpes Zoster Ophthalmicus Complicated by Unilateral Ptosis and Abducens Nerve Palsy: A Case Report.

Herpes zoster ophthalmicus (HZO) is a viral condition that presents as a painful vesicular rash in the trigeminal nerve dermatome. In some cases, self-limiting extraocular muscle palsies may occur several weeks after the onset of HZO and last for weeks to months. A 71-year-old man developed a debilitating binocular horizontal diplopia and ptosis about four weeks after the onset of HZO symptoms. He had no uveitis, keratitis, or changes in visual acuity. Examination revealed left abducens palsy and ptosis. Symptoms resolved within eight weeks without any intervention.

Porphyromonas gingivalis Placental Atopobiosis and Inflammatory Responses in Women With Adverse Pregnancy Outcomes.

The microbiome modulates inflammation at the fetal maternal interface on both term and preterm labor. Inflammophilic oral bacteria, such as Porphyromonas gingivalis, as well as urogenital microorganisms (UGM) could translocate to the placenta and activate immune mechanisms in decidual tissue that is associated with adverse pregnancy outcomes (APO). This study establishes the associations between the presence of microbes in the placenta and placental cytokine patterns in women who presented APO, e.g., low birth weight (LBW), preterm premature rupture of membranes (PPROM), preterm birth (PTB) and other clinical signs related to Chorioamnionitis (CA). A total of 40 pregnant women were included in the study and divided into five groups according to placental infection (PI) and APO, as follows: (1) women without PI and without APO (n = 17), (2) women with P. gingivalis-related PI and APO (n = 5), (3) women with P. gingivalis-related PI and without APO (n = 4), (4) women with PI related to UGM and APO (n = 5) and (5) women without PI with APO (n = 9). Obstetric, clinical periodontal status evaluation, and subgingival plaque sampling were performed at the time of delivery. Placental levels of interleukin IL-1ß, IL-6, IL-10, IL-15, IL-17A, IL-17F, IL-21, IL-12p70, tumor necrosis factor-α (TNF-α), monocyte chemoattractant protein-1 α (MCP-1α), granzyme B, and interferon-γ (IFN-γ) were determined using a multiplex flow cytometry assay. All patients showed a predominant Th-1 cytokine profile related to labor, characterized by IFN-γ overexpression. The analysis by groups suggests that Th-1 profile was trending to maintain cytotoxic cell activity by the expression of IL-15 and granzyme B, except for the group with P. gingivalis-related PI and APO, which exhibited a reduction of IL-10 and IL-17F cytokines (p < 0.05) and a Th-1 profile favoring macrophage activation by MCP-1 production (p < 0.05). This study confirms a pro-inflammatory pattern associated with labor, characterized by a Th-1 profile and the activity of cytotoxic cells, which is enhanced by PI with UGM. However, PI associated with P. gingivalis suggests a switch where the Th-1 profile favors an inflammatory response mediated by MCP-1 and macrophage activity as a mechanistic explanation of its possible relationship with adverse outcomes in pregnancy.

Periodontal condition is associated with adverse perinatal outcomes and premature rupture of membranes in low-income pregnant women in Bogota, Colombia: a case-control study.

Objectives: To assess the periodontal condition as a factor associated with adverse perinatal outcomes, premature rupture of membranes (PRM), and preeclampsia in low-income pregnant women treated at public hospitals in Bogotá, Colombia.Methods: Pregnant women with preterm birth (PTB) and low birth weight (LBW) or both conditions (n = 107/428), or only PTB (n = 73/292) or LBW (n = 74/296) or with PRM (n = 98/392) or preeclampsia (n = 76/304) in a ratio of four controls for each case, coming from three hospitals of the public Northern Network of Bogotá, Colombia were studied. Sociodemographic, perinatal adverse outcome history, antenatal care, chronic infections, periodontal condition, threatened abortion, bleeding in the second half of pregnancy, oligohydramnios, diabetes, gestational diabetes, alcohol consumption, hypertension, smoking, alcohol during pregnancy were determined. Logistic regression was conducted to establish factors associated to perinatal adverse outcomes. Multiple correspondence analysis was conducted as secondary analysis.Results: Threatened abortion, absence of antenatal care, hypertension, chronic infections, and periodontal condition were the most important factors associated with perinatal adverse outcomes. The presence of periodontal pockets was associated with LBW OR 2.52 (IC95% 1.36-4.70), PTB OR 2.04 (IC95% 1.10-3.64), PTB-LBW or both OR 2.08 (IC95% 1.18-3.31), PRM OR 2.04 (IC95% 1.17-3.56). Periodontal pockets presence was not associated with preeclampsia. Multiple correspondence analyses showed high correlation between PRM with chronic infection and presence of periodontal pockets.Conclusions: Periodontal condition is a factor independent of other important risk factors for a perinatal adverse outcome and PRM. Prevention of periodontal disease should be included in preconception and prenatal care programs.

Oral and uro-vaginal intra-amniotic infection in women with preterm delivery: A case-control study.

AIM: The aim of the present study was to establish the association between the presence of oral and uro-vaginal microorganisms in the placental membrane and preterm delivery (PTD), the premature rupture of membranes (PRM), and the clinical signs of intra-amniotic infection. METHODS: Eighty-four women with PTD and 127 women with delivery at term were assessed for the PRM, clinical signs of intra-amniotic infection, and the presence of periodontitis. Twenty-seven microorganisms were identified in the placental tissue using nested polymerase chain reaction (PCR). Porphyromonas gingivalis (P. gingivalis) was quantified by droplet digital PCR. RESULTS: The prevalence of microorganisms was 9.47% (20/211). P. gingivalis was the most prevalent (12/211, 5.68%). Mycoplasma hominis, Ureaplasma urealyticum, Staphylococcus spp, and Fusobacterium nucleatum were isolated at a very low frequency in the placenta. Candida albicans was associated with PTD (P = 0.027). Periodontitis was associated with clinical signs of infection (odds ratio [OR] = 3.8, 95% confidence interval [CI]: 1.28-13.5) and with PTD (OR = 1.99; 95% CI: 1.07-3.72). CONCLUSION: The presence of P. gingivalis in the placenta was not associated with perinatal complications. Detecting microorganisms in the placenta by nested PCR is not relevant, as it has a poor association with clinical variables that establish the diagnosis of chorioamnionitis. However, periodontitis was associated with the clinical signs of intra-amniotic infection and PTD.

Inactivation of the miR-183/96/182 Cluster Decreases the Severity of Pseudomonas aeruginosa-Induced Keratitis.

PURPOSE: The microRNA-183/96/182 cluster (miR-183/96/182) plays important roles in sensory organs. Because the cornea is replete with sensory innervation, we hypothesized that miR-183/96/182 modulates the corneal response to bacterial infection through regulation of neuroimmune interactions. METHODS: Eight-week-old miR-183/96/182 knockout (ko) mice and their wild-type littermates (wt) were used. The central cornea of anesthetized mice was scarred and infected with Pseudomonas aeruginosa (PA), strain 19660. Corneal disease was graded at 1, 3, and 5 days postinfection (dpi). Corneal RNA was harvested for quantitative RT-PCR. Polymorphonuclear neutrophils (PMN) were enumerated by myeloperoxidase assays; the number of viable bacteria was determined by plate counts, and ELISA assays were performed to determine cytokine protein levels. A macrophage (Mϕ) cell line and elicited peritoneal PMN were used for in vitro functional assays. RESULTS: MicroRNA-183/96/182 is expressed in the cornea, and in Mϕ and PMN of both mice and humans. Inactivation of miR-183/96/182 resulted in decreased corneal nerve density compared with wt mice. Overexpression of miR-183/96/182 in Mϕ decreased, whereas knockdown or inactivation of miR-183/96/182 in Mϕ and PMN increased their capacity for phagocytosis and intracellular killing of PA. In PA-infected corneas, ko mice showed decreased proinflammatory neuropeptides such as substance P and chemoattractant molecules, MIP-2, MCP1, and ICAM1; decreased number of PMN at 1 and 5 dpi; increased viable bacterial load at 1 dpi, but decreased at 5 dpi; and markedly decreased corneal disease. CONCLUSIONS: MicroRNA-183/96/182 modulates the corneal response to bacterial infection through its regulation of corneal innervation and innate immunity.

Responsabilidad de la psicología en la conformación de los derechos humanos / Responsibility of the psychology in the conformation from the human rights

Existe cierto interés en el tema de los derechos humanos al punto que se ha generalizado su uso en diferentes esferas tanto cotidianas como académicas. Por esto, el texto hace una reflexión frente al que hacer de la psicología y la vinculación de los derechos humanos en la práctica profesional.

There is some interest in the subject of human rights to the point that has been widespread use in different spheres both every day and academic. The text reflects about which make psychology and linking human rights in practice.

Padronização do critério de exclusão para o vírus HTLV I e II nos bancos de olhos do Brasil / Standardization of the exclusion criteria for the HTLV I and II in brazilian eye banks

RESUMO Objetivo: Investigar em quais Bancos de olhos do Brasil o HTLV I e II é utilizado como critério de exclusão para córnea. Atualmente a legislação brasileira pela Lei nº 9.434/97 e Portaria 2600/09 determina que a cada doação devem ser realizados, obrigatoriamente, testes laboratoriais de triagem de alta sensibilidade, para detecção de marcadores para doenças infecciosas transmissíveis pelo sangue: Vírus da Imunodeficiência Humana (HIV), Vírus da Hepatite B (HbsAg), Anticorpo do Vírus da Hepatite B (AntiHBs), Anticorpo do Vírus da Hepetite B total (Anti-HBc total) e Vírus da Hepatite C (Anti-HCV), no entanto, o Capítulo VI, art. 47, alínea a exclui o Vírus Linfotrópico das Células T-Humanas (HTLV) como critério de exclusão para doadores de córnea. Métodos: Para a realização da pesquisa, foram analisadas as informações de 35 Bancos de Olhos pela base de dados da Central de Transplante da Paraíba, avaliados através do Teste de Homogeneidade do Qui-Quadrado. Resultados: Constatou-se que a sorologia positiva para HTLV I e II foi considerada critério de exclusão em 18 dos 35 Bancos de Olhos analisados. Quanto à análise geográfica dos Bancos de Olhos do Brasil, os da região Nordeste e Sul foram os que mais consideraram o HTLV como critério de exclusão. Conclusão: Os Bancos de Olhos analisados não apresentaram diferença ou associação significativa entre os que consideram e os que não consideram este critério, mostrando, desta forma, não haver uma padronização entre os Bancos de Olhos do Brasil.

ABSTRACT Objective: Investigate in which eye banks in Brazil the HTLV I and II is used as exclusion criteria for cornea. Nowadays Brazilian Legislation, through Law nº 9.434/97 and Ordinance 2600/09 determines that for each donation, laboratory screening tests of high sensibility must be done mandatorily for detection of markers of infectious diseases transmissible by blood: Human Immunodeficiency Virus (HIV), Hepatitis B Virus (HbsAg), Antibody of the Hepatitis B Virus (AntiHBs), Antibody of total Hepatitis B Virus (total Anti- HBc) and Hepatitis C Virus (Anti-HCV), however, paragraph a of Chapter VI, Art. 47 excludes the HTLV as exclusion criteria for cornea donors. Methods: For the realization of this research, information from 35 eye banks was analyzed, through the database of the Transplant Central of Paraiba, evaluated through the Chi-Square Homogeneity Test. Results: It was observed that the positive serology for HTLV I and II was considered exclusion criteria in 18 of the 35 eye banks analyzed. In relation to the geographic analysis of the Eye Banks in Brazil, the ones in the Northeastern and Southern regions were the ones that most considered the HTLV as exclusion criteria. Conclusion: The analyzed Eye Banks did not present difference or significant association between the ones that consider and the ones that do not consider this criterion, showing, this way, that there is not a standardization among the Eye Banks in Brazil.

Efectividad y seguridad de atosiban en mujeres embarazadas con trabajo de parto pretérmino / Dexrazoxane to Prevent Cardiac Damage in Patients Under 18 with Hodgkin's Lymphoma or Acute Lymphoid Leukemia on Chemotherapy with Anthracyclines

Introducción: el parto pretérmino es definido como el parto producido antes de la semana 37 de edad gestacional. En Colombia es la principal causa de la morbilidad y mortalidad en el período neonatal. La incidencia del parto prematuro es cercana al 12%, con tasas estables en las últimas décadas, que se pueden deber a la complejidad de fisiopatología o a la falta de conocimientos de la condición. Es responsable a nivel mundial de la muerte en menores de 1 año. Objetivo: evaluar la efectividad y seguridad del atosiban en mujeres gestantes con trabajo de parto pretérmino. Metodología: la evaluación fue realizada de acuerdo con un protocolo definido a priori. Se realizó una búsqueda sistemática hasta noviembre de 2014 en MEDLINE, EMBASE, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects y LILACS, sin restricciones de idioma ni fecha de publicación. Se identificaron las RSL y ECA que cumplieran los criterios de elegibilidad. La calidad de los estudios fue valorada con la herramienta AMSTAR. Las características de los estudios fueron extraídas a partir de las publicaciones originales. Los resultados se presentan de acuerdo al reporte de la RSL. Resultados: el atosiban no disminuye la proporción de parto antes de las 48 horas de inicio del tratamiento comparado contra placebo con un RR=1.05 (IC 95% 0,15-7,43), ni comparado contra betamiméticos RR=0,89 (IC 95% 0,66-1,22), ni comparado contra nifedipino RR=1,09 (IC 95% 0,44-2,73). Tampoco disminuye el parto antes de la semana 37 con un RR=1,17 (IC 95% 0,99-1,37) al compararlo contra el placebo y de 1,56 (IC 95% 1,13-2,14) al compararlo contra la nifedipina. Aumentó la probabilidad de parto antes de la semana 28 al compararse contra el placebo RR=3,11 (IC 95% 1,02-9,51). Mostró un mejor perfil de seguridad para eventos adversos maternos al compararlo contra betamiméticos RR=0,47 (IC 95% 0,35-0,62) y contra nifedipino RR=0,38 (IC 95% 0,21-0,68), pero no contra placebo. Conclusiones: no existe evidencia a favor del uso de atosiban en vez de placebo, betamiméticos o nifedipino para la disminución del parto pretérmino antes de la semana 37 ni 28 de edad gestacional. Tampoco disminuye la proporción de partos pretérminos antes de las 48 horas de inicio del tratamiento. El atosiban no fue superior a los comparadores para disminuir los eventos adversos neonatales. Mostró beneficio para la disminución de los efectos adversos maternos cuando se comparó contra betamiméticos o nifedipino. Los ECA incluidos en la RSL identificada tienen alta probabilidad de sesgos por lo cual los resultados se deben evaluar con precaución.(AU)

Psicología y posconflicto: un acercamiento a la psicología de la paz / Psychology and post-conflict: an approach to the psychology of peace

Colombia atraviesa una de las coyunturas más interesantes de los últimos tiempos gracias a los procesos de negociación de la paz. En esta medida, se hace necesario que la psicología identifique su lugar dentro de los procesos de transición hacia la paz. El texto hace una reflexión sobre la importancia de la psicología, en especial de la psicología de la paz, para preparar a los profesionales frente a las demandas de intervención acordes al momento por el que transita el país. Además de esto, se propone la necesidad de orientar los conocimientos psicológicos hacia la coyuntura.

Colombia goes through one of the most interesting situations for the peace negotiation process. Thus, is necessary that psychology identifies its position into transition processes towards peace. The text reflects on importance of psychology, particularly the psychology of peace, to prepare the professionals handle the intervention request according to the period that the country moves. In addition, is consider the propose to orient psychological knowledge to the situation.

miR-210 targets iron-sulfur cluster scaffold homologue in human trophoblast cell lines: siderosis of interstitial trophoblasts as a novel pathology of preterm preeclampsia and small-for-gestational-age pregnancies.

This study was performed to assess the biological significance of miR-210 in preeclampsia and small-for-gestational-age (SGA) pregnancies. Placental miR-210 expression was evaluated by quantitative RT-PCR (RT-qPCR) in the following groups: i) appropriate-for-gestational-age pregnancies (n = 72), ii) preeclampsia (n = 52), iii) SGA (n = 66), and iv)preeclampsia with SGA (n = 31). The effects of hypoxia (1% O(2)) on miR-210 and iron-sulfur cluster scaffold homologue (ISCU) expressions and miR-210 binding to ISCU 3' UTR were examined in Swan 71 and BeWo cell lines. Perls' reaction (n = 229) and electron microscopy (n = 3) were conducted to verify siderosis of trophoblasts. miR-210 expression was increased in preeclampsia and SGA cases and was decreased with birth weight and gestational age. In both cell lines, miR-210 was induced by hypoxia, whereas ISCU expression was decreased. The luciferase assay confirmed miR-210 binding to ISCU mRNA 3' UTR. RNA interference knockdown of ISCU expression in Swan 71, but not in BeWo, cells resulted in autophagosomal and siderosomal iron accumulation and a fourfold decrease of Matrigel invasion (P = 0.004). Placental ISCU expression was decreased in preeclampsia (P = 0.002) and SGA (P = 0.002) cases. Furthermore, hemosiderin-laden trophoblasts were more frequent in the placental bed of preterm preeclampsia and/or SGA births than in control cases (48.7% versus 17.9%; P = 0.004). Siderosis of interstitial trophoblasts is a novel pathological feature of preeclampsia and SGA. The findings herein suggest that ISCU down-regulation by miR-210 perturbing trophoblast iron metabolism is associated with defective placentation.

MicroRNA expression profiling of the human uterine cervix after term labor and delivery.

OBJECTIVE: MicroRNAs (miRNAs) are noncoding RNAs involved in posttranscriptional regulation of target genes. The objective of this study was to determine the miRNA expression profile of the human uterine cervix after spontaneous term labor (TL). STUDY DESIGN: The miRNA expression pattern of cervical tissue was characterized using microarrays. Samples were collected at term from patients with (n = 8) and without (n = 9) TL. Moderated t tests and false discovery rate correction were applied. Results were confirmed using quantitative reverse transcriptase-polymerase chain reaction. RESULTS: A total of 226 miRNAs were expressed in human cervical tissue. miR-223, miR-34b, and miR-34c were overexpressed in cervical tissue of patients with TL compared to those without. Quantitative reverse transcriptase-polymerase chain reaction assays confirmed these findings (miR-223 [fold change {FC} = 5.7], miR-34b [FC = 4.5], miR-34c [FC = 6.2]; P < .001). CONCLUSION: This is the first report of miRNA expression in the human uterine cervix in pregnancy. Cervical remodeling after TL and delivery was associated with changes in miR-223, miR-34b, and miR-34c.

Chorioamnionitis and increased galectin-1 expression in PPROM --an anti-inflammatory response in the fetal membranes?

PROBLEM: Galectin-1 can regulate immune responses upon infection and inflammation. We determined galectin-1 expression in the chorioamniotic membranes and its changes during histological chorioamnionitis. METHOD OF STUDY: Chorioamniotic membranes were obtained from women with normal pregnancy (n = 5) and from patients with pre-term pre-labor rupture of the membranes (PPROM) with (n = 8) and without histological chorioamnionitis (n = 8). Galectin-1 mRNA and protein were localized by in situ hybridization and immunohistochemistry. Galectin-1 mRNA expression was also determined by quantitative reverse transcriptase polymerase chain reaction. RESULTS: Galectin-1 mRNA and protein were detected in the amniotic epithelium, chorioamniotic fibroblasts/myofibroblasts and macrophages, chorionic trophoblasts, and decidual stromal cells. In patients with PPROM, galectin-1 mRNA expression in the fetal membranes was higher (2.07-fold, P = 0.002) in those with chorioamnionitis than in those without. Moreover, chorioamionitis was associated with a strong galectin-1 immunostaining in amniotic epithelium, chorioamniotic mesodermal cells, and apoptotic bodies. CONCLUSION: Chorioamnionitis is associated with an increased galectin-1 mRNA expression and strong immunoreactivity of the chorioamniotic membranes; thus, galectin-1 may be involved in the regulation of the inflammatory responses to chorioamniotic infection.

Differential expression of microRNAs with progression of gestation and inflammation in the human chorioamniotic membranes.

OBJECTIVE: The aim of this study was to identify differential expression of microRNAs (miRNAs) in chorioamniotic membranes with advancing gestation, labor, and inflammation. STUDY DESIGN: Expression profiles of 157 miRNAs in the chorioamniotic membranes were obtained from patients in the following groups: 1) term not in labor (n = 10); 2) term in labor (n = 10); 3) preterm labor with histologic chorioamionitis (n = 9); and 4) without histologic chorioamnionitis (n = 10). RESULTS: More than 95% of the miRNAs screened were expressed. Gestational age-dependent changes in expression were observed for 13 miRNAs. No differences in miRNA expression were observed between women without labor and women in labor. Membranes with chorioamnionitis displayed increased expression of miR-223 and miR-338. Gene Ontology analysis of genes targeted by differentially expressed miRNAs revealed enrichment for specific biological process categories. CONCLUSION: Chorioamniotic membranes with advancing gestational age and chorioamnionitis are associated with the differential expression of a subset of miRNAs.

Distinct subsets of microRNAs are expressed differentially in the human placentas of patients with preeclampsia.

OBJECTIVE: Preeclampsia and small-for-gestational age (SGA) neonates have partially overlapping clinicopathologic features. MicroRNAs (miRNAs) are critical posttranscriptional regulators of gene expression. This study was performed to determine whether preeclampsia and SGA are associated with alterations in placental miRNA expression. STUDY DESIGN: Placentas were obtained from patients with (1) preeclampsia (n = 9); (2) SGA (n = 9); (3) preeclampsia + SGA (n = 9); and (4) a control group with spontaneous preterm labor and delivery (PTL; n = 9). The expression of 157 miRNAs was assessed by real-time quantitative reverse transcription-polymerase chain reaction. RESULTS: Differential expression between preeclampsia and the control group (miR-210, miR-182) and between preeclampsia + SGA and the control group (miR-210, miR-182*, and others) was found. Gene Ontology analysis of the target genes revealed enrichment for specific biological process categories (antiapoptosis: miR-182; regulation of transcription: miR-210). CONCLUSION: This study reports, for the first time, increased expression of specific placental miRNAs in preeclampsia with and without SGA. The findings also provide novel targets for further investigation of the pathophysiology of preeclampsia.

Effect of the ABO blood group on the proliferative and clonogenic capacity of umbilical cord stem cells.

Possible effects of the ABO blood group on the proliferative and self-renewal capacity of umbilical cord CD34+ cells were evaluated. A, B and O (all Rh D+) CD34+ cells isolated from three placental blood samples were cultured in four platforms with hematopoietic growth factors on a 3-dimensional biocompatible matrix. Results from this study suggest that proliferation of CD34+ cells with the O phenotype may be greater than that of cells with the A or B phenotypes. Further ex vivo studies are required to confirm this finding and to determine the effect of the number and type of other genetically determined cell surface antigens on the capacity of hematopoietic stem cells to respond to cytokines. In addition, clinical studies aimed at determining if the CD34+ donor blood group affects the time to functional hematological reconstitution are recommended.

Inversión uterina puerperal crónica: presentación de un caso y revisión de la literatura / Chronic uterine inversion: a case report and review of the literature

Se presenta un caso de diagnóstico tardío de inversión uterina poco frecuente en la literatura médica. El cuadro clínico de la paciente incluía sangrado genital moderado persistente y dispareunia de 14 meses de evolución. La técnica de reposicionamiento uterino se realizó por vía vaginal con revisión posterior por vía laparoscópica y evolución satisfactoria. Se hace una revisión de la literatura.

Prevalence of biomicroscopic findings in the anterior segment and ocular adnexa among schoolchildren in Natal/Brazil.

OBJECTIVE: To determine the prevalence of ocular findings of the external structures and anterior segment of the eye, detected by biomicroscopic examination in schoolchildren in Natal (RN)-Brazil. METHODS: After previous random selection, 1,024 pupils from elementary and secondary public and private schools in the city of Natal were evaluated from March to June 2001. All were submitted to preestablished standard research norms, consisting of identification, demographic information, ophthalmologic biomicroscopic examination, with slit lamp, performed by ophthalmologists from the "Onofre Lopes" University Hospital. RESULTS: Alterations of the conjunctival and palpebral conditions were the most prevalent (10.4% and 6.2% respectively). Follicles (4.2%) and papillae (3.0%) were the frequent conjunctival lesions, while blepharitis (3.5%) and meibomitis (1.1%) were the most detected abnormalities in the eyelids. Upon examining the cornea, iris, lens and anterior vitreous, the most encountered findings were nubecula (0.5%), papillary membrane reliquiae (0.5%), posterior capsula opacity (0.8%) and hyaloid arteria reliquiae (2.0%). CONCLUSION: The most prevalent findings affecting the external structures of the eye such as eyelids and conjunctiva, consisted of blepharitis followed by follicular reaction of the conjunctiva. The most prevalent abnormalities in the cornea, iris, lens and anterior vitreous were nubecula, papillary membrane reliquiae, posterior capsular opacity and hyaloid arteria reliquiae, in that order.

Prevalence of biomicroscopic findings in the anterior segment and ocular adnexa among schoolchildren in Natal/Brazil

OBJETIVO: Determinar a prevalência dos achados oculares das estruturas externas e segmento anterior do olho detectados ao exame biomicroscópico em uma população de estudantes de Natal (RN) - Brasil. MÉTODOS: 1024 escolares do ensino fundamental e médio de escolas públicas e privadas da cidade de Natal foram avaliados de março a junho de 2001 após seleção randomizada prévia. Todos foram submetidos a protocolo de pesquisa pré-estabelecido consistindo em identificação, dados demográficos e exame oftalmológico biomicroscópico com lâmpada de fenda, realizados por oftalmologistas do Hospital Universitário Onofre Lopes. RESULTADOS: As alterações da conjuntiva e das pálpebras foram as mais prevalentes, (10,4% e 6,2% respectivamente). Dentre estas, folículos e papilas conjuntivais representaram os achados mais evidenciados ao exame da conjuntiva (4,2% e 3,0% respectivamente), ao passo que blefarite anterior (3,5%) e meibomite (1,1%) foram as anormalidades mais encontradas nas pálpebras. Ao exame da córnea, íris, cristalino e vítreo anterior, os achados mais freqüentes foram: nubécula (0,5%), restos da membrana pupilar (0,5%), opacidade de cápsula posterior (0,8%) e resquício da artéria hialóide (2,0%). CONCLUSAO: Os achados mais prevalentes acometeram com maior freqüência as estruturas externas do olho (pálpebras e conjuntivas), tendo como seus principais representantes a blefarite anterior e reação folicular da conjuntiva, respectivamente. Já as anormalidades mais evidenciadas na córnea, íris, cristalino e vítreo anterior foram: nubécula, resquício da membrana pupilar, opacidade da cápsula posterior e resquício da artéria hialóide, nesta ordem.

Complicações infecciosas na síndrome nefrótica / Nefhrotic syndrome: infeccious complications

Complicações infecciosas são freqüentes nos pacientes portadores de síndrome nefrótica, em decorrência não somente da grande perda protéica urinária , mas também em função de alterações da imunidade celular e humoral, contribuindo com a morbi-mortalidade destes pacientes e passíveis de prevenção com medidas profiláticas adequadas. Os autores, relatam um caso de Síndrome Nefrótica em menino de 10 anos, internado na Enfermaria de Pediatria do Hospital Universitário Lauro Wanderley por pneumonia evoluindo com celulite e piora da doença de base. O tratamento da pneumonia foi realizado com penicilina cristalina (100.000 U/KG/dia) e da celulite com cefalotina (100 mg/kg/dia), apresentando evolução clínica satisfatória. Também revisam aspectos das complicações infecciosas no paciente nefrótico, através de revisão bibliográfica da literatura