Evaluation of ocular involvement in patients with Hansen's disease.

Hansen's disease (HD) belongs to the group of neglected diseases and can cause physical deformities and disabilities, in addition to leading to social discrimination. Ocular involvement in HD is estimated at 70-75% worldwide. About 10-50% suffer from severe ocular symptoms and loss of vision occurs in approximately 5% of cases. Ocular changes may persist or worsen even after patients are considered cured and it is necessary to better understand these conditions in order to determine the need for additional public policies. The objective of this study was to identify the prevalence of ocular involvement in patients with HD at two specialist referral centers for treatment of the disease. A cross-sectional study was conducted with ophthalmological evaluations of patients with HD from June 2017 to June 2018. Diagnostic ocular findings, corrected visual acuity, and refractive error were described. Findings were correlated with patients' clinical and epidemiological variables. A total of 86 patients were evaluated, with a mean age of 50.1 years, predominantly males (59.3%), and with multibacillary HD (92%). The prevalence of ophthalmologic changes was 100% and the most common were dysfunction of the Meibomian glands (89.5%) and dry eye syndrome (81.4%). Cataracts were observed in 22 patients (25.6%), but best corrected visual acuity was normal or near normal in 84 patients (97.7%) and there were no cases of bilateral blindness. Patients with some degree of physical disability had more ophthalmological alterations, involving both the ocular adnexa (p = 0.03) and the ocular globe (p = 0.04). Ocular involvement is common in patients with Hansen's disease, reinforcing the importance of ophthalmologic examination in the evaluation and follow-up of these patients.

Analysis of the use of drugs in cardiovascular and antidiabetic primary health care according to age / Análise do uso de medicamentos cardiovasculares e antidiabéticos em atenção primária de saúde de acordo com a faixa etária

The population of elderly and non-elderly users of a Basic Health Unit (UBS) was interviewed regarding the use of cardiovascular and anti-diabetic medications, as well as the adverse effects that were noted. Hypertension and diabetes mellitus are conditions involving complications and compromise the quality of life of patients. The objective was to build a profile of these users. The cross-sectional study was carried out on patients older than 18 years of age and users of cardiovascular or anti-diabetic drugs in Centro Social Urbano UBS, located in Londrina ­ PR, Brazil. The result revealed the following statistically significant variables: lower use of beta blockers (p = 0.012) and metformin (p = 0.05) among the elderly compared to the overall average, and higher acetylsalicylic acid (ASA) (p = 0.006) use in people over 64 years of age. Reported adverse symptoms were lower among those over 64 years old (p = 0.03). Angiotensin-converting enzyme (ACE) inhibitors are the most used (63.5%), followed by diuretics (54.9%) and beta-blockers (27.7%). Among diabetic patients, 23.2% were using biguanides and 15.9% sulfonylureas; only 6.6% were insulin-dependent.

A população de idosos e não-idosos usuários de uma unidade básica de saúde (UBS) foi entrevistada quanto ao uso de medicamentos cardiovasculares e antidiabéticos e, também, aos efeitos adversos que eram notados pelos próprios entrevistados. A Hipertensão Arterial Sistêmica e o Diabetes Mellitus são afecções relacionadas a complicações e comprometimento da qualidade de vida dos pacientes. O objetivo foi montar o perfil desses usuários. O estudo foi transversal, realizado com pacientes maiores de 18 anos de idade usuários de medicamentos cardiovasculares e ou antidiabéticos da UBS ­ Centro Social Urbano, em Londrina, Estado do Paraná. O resultado revelou, estatisticamente significativas, as variáveis: uso de betabloqueadores (p = 0,012) e de metformina (p = 0,05) menor entre os idosos em relação ao total e de ácido acetilsalicílico (AAS) (p = 0,006) maior nas pessoas acima de 64 anos. Os sintomas adversos referidos foi estatisticamente menor entre aqueles com mais de 64 anos (p = 0,03). Os inibidores da enzima de conversão da angiotensina (IECA) são os mais utilizados (63,5%), seguidos por diuréticos tiazídicos (54,9%) e beta-bloqueadores (27,7%). Entre os pacientes diabéticos, 23,2% utilizam biguanidas e 15,9% sulfanilureias, apenas 6,6% fazem uso de insulina. Conclui-se que as terapias medicamentosas da amostra estavam, em sua maioria, de acordo com as diretrizes atuais.