Open-globe injuries at an emergency department in Porto, Portugal: clinical features and prognostic factors.

PURPOSE: To describe the epidemiology, characteristics, surgical management, functional outcome, and prognostic factors of open-globe injuries requiring surgical treatment. METHODS: A retrospective review of 180 patients who underwent surgical repair of an open-globe injury at the ophthalmology emergency department of the Hospital S. João (Porto-Portugal) was performed. Prognostic factors for no light perception and for poor vision (visual acuity <3/10) in patients who retained vision after surgical treatment were determined. RESULTS: We observed a different age distribution between male and female ocular trauma (143 patients were men, with a mean age of 46.4 years, while the mean age for women was 70.9 years). Domestic accidents were the most frequent context of trauma (44.4%). However, work accidents constituted the principal context of trauma among men. Initial visual acuity, concomitant adnexa lesion, associated nonocular trauma, and intentionally caused trauma were predictors of no vision at the end of the follow-up. Older age, lens damage, and retinal detachment were predictors of poor vision in patients with retained visual acuity. Vitreous hemorrhage, posterior segment lesion, and simultaneous lesion of anterior and posterior segment anticipated both no vision and poor vision. Isolated anterior segment lesion was associated with vision survival and good vision (≥3/10). CONCLUSIONS: The prognostic factors identified in this study may aid the process of decision-making in 2 crucial moments: at the initial approach and during the follow-up of patients with vision survival after open-globe injuries.

Mensagem de um urologista a um generalista: avaliaçäo prostática / Message from the urologist to general Practitioner: prostatic evaluation

O paciente prostático é aquele que refere uma série de sintomas miccionais irritativos e obstrutivos atribuídos ao trato urinário baixo. A Hiperplasia Prostática Benigna (HPB) é a principal responsável por esta sintomatologia, de alta incidência em homens a partir dos 50 anos, com significativa morbidade sobretudo com o aumento da expectativa de vida da populaçäo. O Consenso Nacional sobre HPB recomenda para a avaliaçäo inicial mínima do paciente prostático: 1- história clínica; 2- sistema internacional de pontuaçäo clínica; 3- toque prostático; 4- EAS; 5- creatinina; 6- PSA (Antígeno Prostático Específico). O surgimento de novas técnicas diagnósticas, a introduçäo de novos medicamentos e formas alternativas de tratamento, além da maior divulgaçäo pela mídia, dos problemas prostáticos, fazem com que profissionais de atençäo primária tenham ampliada sua participaçäo na avaliaçäo inicial destes pacientes, selecionando aqueles que podem ficar aos seus próprios cuidados e os que devem ser encaminhados ao Urologista.