Boosting Gold(I) Catalysis via Weak Interactions: New Fine-Tunable Impy Ligands.

A series of modular ImPy-carbene-Au(I) complexes are synthesized and fully characterized both in the solid state and in solution. The presence of oligoaryl units (phenyl and thienyl rings) at the C5-position of the ImPy core (in close proximity to the gold center) imprints on the organometallic species fine-tunable and predictable catalytic properties. A marked accelerating effect was recorded in several [Au(I)]-catalyzed electrophilic activations of unsaturated hydrocarbons when a CF3-containing aromatic ring was accommodated at the ImPy core.

Addressing disparities and challenges in underserved patient populations with metastatic breast cancer in Europe.

People with metastatic breast cancer face many challenges and disparities in obtaining optimal cancer care. These challenges are accentuated in underserved patient populations across Europe, who are less likely to receive quality healthcare for reasons including socioeconomic inequalities, educational or cultural status, or geographic location. While there are many local and national initiatives targeted to address these challenges, there remains a need to reduce disparities and improve access to healthcare to improve outcomes, with a focus on multidisciplinary stakeholder engagement. In October 2019, a range of experts in metastatic breast cancer, including healthcare professionals, patient representatives, policymakers and politicians, met to discuss and prioritize the critical needs of underserved patient populations with metastatic breast cancer in Europe. Six key challenges faced by these communities were identified: the need for amplification of the metastatic breast cancer patient voice, better and wider implementation of high-quality guidelines for metastatic breast cancer, more collaboration between stakeholders, tailored support for patients from different cultural and ethnic backgrounds, improved data sharing, and work-related issues. The Expert Panel then conceived and discussed potential actionable goals to address each key challenge. Their conclusions present a set of interrelated approaches to address the different challenges and could serve as the basis for concerted improvement of the lives of patients with metastatic breast cancer in Europe.

Antimicrobial action of 1,10-phenanthroline-based compounds on carbapenemase-producing Acinetobacter baumannii clinical strains: efficacy against planktonic- and biofilm-growing cells.

Therapeutic options are limited for patients infected with Acinetobacter baumannii due to its multidrug-resistance profile. So, the search for new antimicrobials against this gram-negative bacterial pathogen has become a worldwide priority. The present study aimed to evaluate the effects of 1,10-phenanthroline (phen), 1,10-phenanthroline-5,6-dione (phendione), [Ag(phendione)2]ClO4 (Ag-phendione) and [Cu(phendione)3](ClO4)2·4H2O (Cu-phendione) on 26 carbapenemase-producing A. baumannii strains. The susceptibility to carbapenems was performed by detecting the metallo-beta-lactamase (MBL) genes by PCR and by determining the MIC. Also, disk diffusion method was applied to evaluate the susceptibility to other antimicrobial classes. The test compounds were evaluated on both planktonic- and biofilm-growing bacterial cells. The results revealed that all A. baumannii strains had the intrinsic blaoxa-51 gene, and at least one of the blaoxa-23 or blaoxa-24 genes. The geometric mean MIC and minimum bactericidal concentration (MBC) values, respectively, were as follows: Cu-phendione (1.56 and 2.30 µM), Ag-phendione (2.48 and 3.63 µM), phendione (9.44 and 9.70 µM), and phen (70.46 and 184.28 µM). The test compounds (at 0.5 × MIC) affected the biofilm formation and disrupted the mature biofilm, in a typically dose-dependent manner, reducing biomass and viability parameters. Collectively, silver and copper-phendione derivatives presented potent antimicrobial action against planktonic- and biofilm-forming cells of carbapenemase-producing A. baumannii.

Transforming Breast Cancer Together: European elections manifesto 2019 seizing the opportunities for breast cancer patients.

With the European Parliament elections having taken place in May 2019 and a new European Commission (EC) taking office in November 2019, this year is critical for European policymakers, as goals and priorities of the European Union (EU) for the next five years will be discussed and agreed upon. This Manifesto issued by the Transforming Breast Cancer Together initiative calls upon policymakers to improve services for patients in an area still of high unmet need and reduce the societal impact of breast cancer by elevating it as a health policy priority to improve breast cancer prevention, diagnosis and care across Europe.

Coliform risk assessment through use of the clam Anomalocardia brasiliana as animal sentinel for shellfish harvesting areas in Brazil's northeast.

Outbreaks of food-borne diseases related to consumption of contaminated shellfish have been reported in many countries, but not in Brazil, possibly due to deficient reporting. Here we investigated the suitability of the clam Anomalocardia brasiliana as an animal sentinel for coliform monitoring in shellfish harvesting areas of Brazil's northeast. Samples of shellfish meats (40 clams per sample; n = 8 per collection) were collected at random from April 2009 through March 2010 in the bay area of Mangue Seco (state of Pernambuco). The numbers of thermotolerant coliforms were analyzed through the most probable number technique, and these contamination levels were tentatively correlated with the precipitation recorded on the day of sampling or 24 to 48 h beforehand. A. brasiliana shellfish meats from local retail shops (250 g per sample/ n = 3 per market) sold frozen were also investigated from August 2010 through June 2011. We found that the highest coliform contamination levels were correlated with recent rainfall events, limited to 24 h before sampling. However, irrespective of the rainfall level, the mean contamination above the Brazilian legal threshold of < 3 × 10(2) MPN/ 100 g for shellfish harvesting areas ranged from 18.7 to 93.7 % of samples analyzed monthly. Additionally, a large number of samples obtained from retail shops were also highly contaminated by coliforms during rainy periods, and therefore were not proper for human consumption. We conclude that A. brasiliana can be successfully used to monitor the contamination levels of coliforms in shellfish harvesting areas in Brazil's northeast coast.

Antimicrobial resistance and detection of the mecA gene besides enterotoxin-encoding genes among coagulase-negative Staphylococci isolated from clam meat of Anomalocardia brasiliana.

The marine clam Anomalocardia brasiliana is a candidate as a sentinel animal to monitor the contamination levels of coliforms in shellfish-harvesting areas of Brazil's northeastern region. The aim of the present study was to search enterotoxin-encoding genes plus the mecA gene among coagulase-negative staphylococci (CNS) isolates from shellfish meats of A. brasiliana. The specimen clam (n=48; 40 clams per sample) was collected during low tide in the bay area of Mangue Seco from April through June 2009, and random samples of chilled and frozen shelled clam meat (n=33; 250 g per sample) were obtained from retail shops from January through March 2012. Seventy-nine CNS isolates were identified, including Staphylococcus xylosus, S. cohnii spp. urealyticus, S. sciuri, and S. lentus. A high percentage of isolates resistant to erythromycin (58.5%), penicillin (51.2%), and tetracycline (43.9%), and the fluoroquinolones levofloxacin (39%) and ciprofloxacin (34.1%) were recorded from those environmental samples. Isolates from retail shops were particularly resistant to oxacillin (55.3%) and penicillin (36.8%). All CNS resistant to oxacillin and/or cefoxitin were positive for the presence of the mecA gene, but phenotypically susceptible to vancomycin. Also, the enterotoxin-encoding genes seg and seh were detected through multiplex-polymerase chain reaction in 77.7% and 88.8% of the isolates from environmental samples, versus 90.5% and 100% of the isolates from retail shops, respectively. The data reveal the risk to public health due to consuming raw or undercooked shellfish containing enterotoxigenic plus methicillin-resistant CNS.

Zoonotic potential of multidrug-resistant extraintestinal pathogenic Escherichia coli obtained from healthy poultry carcasses in Salvador, Brazil

The zoonotic potential to cause human and/or animal infections among multidrug-resistant extraintestinal pathogenic Escherichia coli from avian origin was investigated. Twenty-seven extraintestinal pathogenic E. coli isolates containing the increased survival gene (iss) were obtained from the livers of healthy and diseased poultry carcasses at two slaughterhouses in Salvador, northeastern Brazil. The antimicrobial resistance-susceptibility profiles were conducted with antibiotics of avian and/or human use by the standardized disc-diffusion method. Antimicrobial resistance was higher for levofloxacin (51.8%), amoxicillin/clavulanic acid (70.4%), ampicillin (81.5%), cefalotin (88.8%), tetracycline (100%) and streptomycin (100%). The minimum inhibitory concentrations above the resistance breakpoints of doxycycline, neomycin, oxytetracycline and enrofloxacin reached, respectively, 88.0%, 100%, 75% and 91.7% of the isolates. Strains with high and low antimicrobial resistance were i.p. administered to Swiss mice, and histopathological examination was carried out seven days after infection. Resistance to goat and human serum complement was also evaluated. The results show that Swiss mice challenged with strain 2B (resistant to 11 antimicrobials) provoked a severe degeneration of hepatocytes besides lymphocytic infiltration in the liver, whereas the spleen showed areas of degeneration of the white and red pulp. Conversely, the spleen and liver of mice challenged with strain 4A (resistant to two antimicrobials) were morphologically preserved. In addition, complement resistance to goat and human serum was high for strain 2B and low for strain 4A. Our data show that multidrug resistance and pathogenesis can be correlated in extraintestinal pathogenic E. coli strains obtained from apparently healthy poultry carcasses, increasing the risk for human public healthy.

Zoonotic potential of multidrug-resistant extraintestinal pathogenic Escherichia coli obtained from healthy poultry carcasses in Salvador, Brazil.

The zoonotic potential to cause human and/or animal infections among multidrug-resistant extraintestinal pathogenic Escherichia coli from avian origin was investigated. Twenty-seven extraintestinal pathogenic E. coli isolates containing the increased survival gene (iss) were obtained from the livers of healthy and diseased poultry carcasses at two slaughterhouses in Salvador, northeastern Brazil. The antimicrobial resistance-susceptibility profiles were conducted with antibiotics of avian and/or human use by the standardized disc-diffusion method. Antimicrobial resistance was higher for levofloxacin (51.8%), amoxicillin/clavulanic acid (70.4%), ampicillin (81.5%), cefalotin (88.8%), tetracycline (100%) and streptomycin (100%). The minimum inhibitory concentrations above the resistance breakpoints of doxycycline, neomycin, oxytetracycline and enrofloxacin reached, respectively, 88.0%, 100%, 75% and 91.7% of the isolates. Strains with high and low antimicrobial resistance were i.p. administered to Swiss mice, and histopathological examination was carried out seven days after infection. Resistance to goat and human serum complement was also evaluated. The results show that Swiss mice challenged with strain 2B (resistant to 11 antimicrobials) provoked a severe degeneration of hepatocytes besides lymphocytic infiltration in the liver, whereas the spleen showed areas of degeneration of the white and red pulp. Conversely, the spleen and liver of mice challenged with strain 4A (resistant to two antimicrobials) were morphologically preserved. In addition, complement resistance to goat and human serum was high for strain 2B and low for strain 4A. Our data show that multidrug resistance and pathogenesis can be correlated in extraintestinal pathogenic E. coli strains obtained from apparently healthy poultry carcasses, increasing the risk for human public healthy.

[Visual impairment impact on the quality of life of the elderly population that uses the public health care system from the western countryside of Pernambuco State, Brazil]. / Impacto do déficit visual na qualidade de vida em idosos usuários do sistema único de saúde vivendo no sertão de Pernambuco.

PURPOSE: To evaluate the impact of visual impairment on the quality of life of the elderly population living in the western countryside of Pernambuco State, located in northeast of Brazil. METHODS: Five hundred and eighty subjects over 59 years of age were interviewed using the Visual Functioning Questionnaire (VFQ). All subjects underwent complete eye examination. The results of the quantitative parameters were expressed by mean ± SD. The results of categorical parameters were expressed by their frequencies. RESULTS: Mean age was of 70 ± 8.1 years. About 86% of the interviewed elderly were illiterate or had incomplete education. The mean complaints were low visual acuity (71.1%) and itching/burning (69.0%). The visual acuity was not normal in 37.4% of the elderly. About 75.0% of the subjects reported to have regular or bad health, and 77.0% reported to have regular or bad vision. The reported quality of life decreased according to the worsening of the visual acuity. CONCLUSION: Visual impairment had a negative impact on the quality of life of the elderly population from the western countryside of Pernambuco State.

Impacto do déficit visual na qualidade de vida em idosos usuários do sistema único de saúde vivendo no sertão de Pernambuco / Visual impairment impact on the quality of life of the elderly population that uses the public health care system from the western countryside of Pernambuco State, Brazil

OBJETIVO: Avaliar o impacto das doenças oculares sobre a qualidade de vida de uma população idosa do sertão de Pernambuco, localizado na região nordeste do Brasil. MÉTODOS: Foram entrevistados 580 indivíduos acima de 59 anos, por meio do questionário de avaliação de qualidade de vida "Visual Functioning Questionnaire" (VFQ). Todos os indivíduos foram submetidos a exame oftalmológico completo. Os resultados das variáveis quantitativas foram expressos por suas médias e desvios- padrão. Os resultados das variáveis qualitativas foram expressos por suas frequências absolutas e relativas. RESULTADOS: A média de idade foi de 70 ± 8,1 anos. Cerca de 86,0% dos entrevistados declararam ser analfabetos ou ter o ensino fundamental incompleto. As principais queixas foram: baixa visual (71,1%) e ardor/prurido (69,0%). A acuidade visual não era normal em 37,4% dos idosos. Por volta de 75,0% dos entrevistados relataram ter saúde regular ou ruim, e 77,0% diziam ter uma visão regular ou ruim. A qualidade de vida foi considerada pior conforme a piora da condição visual do idoso. CONCLUSÃO: O déficit visual representou um impacto negativo sobre a qualidade de vida dos idosos do sertão Pernambucano.

PURPOSE: To evaluate the impact of visual impairment on the quality of life of the elderly population living in the western countryside of Pernambuco State, located in northeast of Brazil. METHODS: Five hundred and eighty subjects over 59 years of age were interviewed using the Visual Functioning Questionnaire (VFQ). All subjects underwent complete eye examination. The results of the quantitative parameters were expressed by mean ± SD. The results of categorical parameters were expressed by their frequencies. RESULTS: Mean age was of 70 ± 8.1 years. About 86% of the interviewed elderly were illiterate or had incomplete education. The mean complaints were low visual acuity (71.1%) and itching/burning (69.0%). The visual acuity was not normal in 37.4% of the elderly. About 75.0% of the subjects reported to have regular or bad health, and 77.0% reported to have regular or bad vision. The reported quality of life decreased according to the worsening of the visual acuity. CONCLUSION: Visual impairment had a negative impact on the quality of life of the elderly population from the western countryside of Pernambuco State.

Diagnosis and management of conjunctival and corneal intraepithelial neoplasia using ultra high-resolution optical coherence tomography.

PURPOSE: To report a novel diagnostic technique and a case series of conjunctival and corneal intraepithelial neoplasia (CCIN) diagnosed and followed up using prototype ultra high-resolution (UHR) optical coherence tomography (OCT). DESIGN: Prospective, noncomparative, interventional case series. PARTICIPANTS: Seven eyes of 7 consecutive patients with CCIN treated using topical interferon alfa-2b or 5-fluorouracil and 7 eyes of 6 consecutive patients with history of surgically excised pterygia. INTERVENTION: Ultra high-resolution OCT imaging of the ocular surface at primary diagnosis of CCIN and during the follow-up period until resolution of the lesion. Ultra high-resolution OCT images of sites of excised pterygia also were captured and compared with images from resolved CCIN patients. MAIN OUTCOME MEASURES: Clinical course and photographs, UHR OCT images, and histopathologic findings. RESULTS: Ultra high-resolution OCT was capable of providing a noninvasive optical biopsy of all examined CCIN lesions. Ultra high-resolution OCT images of the lesions disclosed a thickened hyperreflective epithelium and abrupt transition from normal to hyperreflective epithelium in all 7 cases. Ultra high-resolution OCT images showed excellent correlation with histopathologic specimens obtained at primary diagnosis of the cases that had incisional biopsies before treatment. All patients were treated medically and were followed up for clinical resolution. In 4 patients, at clinical resolution, UHR OCT images also showed normal epithelial configuration at the site of the treated lesions. In 3 patients, despite apparent clinical resolution, the UHR OCT was able to detect residual disease that was clinically invisible. Continuation of treatment resulted in complete resolution of the residual lesions on the UHR OCT images in all cases. Ultra high-resolution OCT images of patients with surgically excised pterygia demonstrated similar findings to resolved CCIN cases. CONCLUSIONS: Ultra high-resolution OCT is a novel noninvasive technique to diagnose and manage medically treated CCIN. Using UHR OCT to guide medical treatment could prevent the premature termination of topical treatment in the presence of subclinical disease. A larger sample size is needed for further validation of its sensitivity and specificity. FINANCIAL DISCLOSURE(S): The author(s) have no proprietary or commercial interest in any materials discussed in this article.

Epithelial ingrowth after Descemet stripping automated endothelial keratoplasty: description of cases and assessment with anterior segment optical coherence tomography.

PURPOSE: To describe 5 cases of epithelial ingrowth after Descemet stripping automated endothelial keratoplasty (DSAEK) and the use of anterior segment optical coherence tomography (AS-OCT) to describe the areas of ingrowth. METHODS: Five cases with epithelial ingrowth after DSAEK were examined with commercially available AS-OCT and/or a novel custom-built ultrahigh resolution (UHR) AS-OCT. Argon laser photocoagulation was also used to confirm epithelial ingrowth on the iris surface. Pathological evidence of epithelial ingrowth was noted in an eye that underwent corneoscleral grafting for extensive ingrowth through a fistulous tract. RESULTS: Epithelial ingrowth was solely in the graft-host interface in 1 case and in both the interface and retrocorneal and iris surfaces in 4 cases. Argon laser photocoagulation on the iris confirmed epithelial ingrowth in 4 cases. The areas of epithelial ingrowth were imaged in 1 case with the Visante AS-OCT and in 3 cases with an UHR-OCT. In 1 case, block excision with corneoscleral grafting was required. CONCLUSIONS: Epithelial ingrowth can occur after DSAEK. This series reports 5 cases of epithelial ingrowth into the interface and/or the retrocorneal surface after DSAEK. Imaging with AS-OCT, specifically the UHR-OCT, and argon laser photocoagulation can help confirm the diagnosis. UHR-OCT imaging of the interface and retrocorneal surfaces can provide clues to the origin of epithelial ingrowth. Four cases were observed. One case underwent corneoscleral grafting with histological confirmation of epithelial ingrowth.

[Association of color vision alterations and the use of oral contraceptives]. / Associação de alterações cromáticas e uso de anticoncepcionais orais.

PURPOSE: To evaluate the association between oral low-dose contraceptives and color vision alterations. METHODS: Were included in the study 30 women, sixteen used oral contraceptive for less than five years (Group I) and 14 used it for more than five years (Group II). The Ishihara, City University Color Vision Test, and the D 15 desaturated tests were used. RESULTS: No characteristic alterations in the chromatic perception were found in any of the groups. CONCLUSION: In the studied sample, low-dose oral contraceptive has not influenced color vision, independent of the time of use.

Associação de alterações cromáticas e uso de anticoncepcionais orais / Association of color vision alterations and the use of oral contraceptives

OBJETIVOS: Avaliar, em mulheres em idade fértil, a associação entre o uso de anticoncepcionais (ACO) orais de baixa dosagem e alterações na visão de cores. MÉTODOS: Foram incluídas no estudo 30 mulheres, 16 usuárias de ACO oral há menos de cinco anos (Grupo I) e 14 usuárias de anticoncepcionais orais há mais de cinco anos (Grupo II). Foram utilizados os testes de Ishihara, City University Color Vision Test e D 15 dessaturado. RESULTADOS: Não foram observados padrões característicos de distúrbio da visão cromática em nenhum teste dos dois grupos. CONCLUSÃO: Na amostra estudada, o uso de ACO oral de baixa dosagem não influenciou a visão de cores, independente do tempo de uso.

PURPOSE: To evaluate the association between oral low-dose contraceptives and color vision alterations. METHODS: Were included in the study 30 women, sixteen used oral contraceptive for less than five years (Group I) and 14 used it for more than five years (Group II). The Ishihara, City University Color Vision Test, and the D 15 desaturated tests were used. RESULTS: No characteristic alterations in the chromatic perception were found in any of the groups. CONCLUSION: In the studied sample, low-dose oral contraceptive has not influenced color vision, independent of the time of use.

["Vision through the hands": experience of a project]. / Experiência em projeto: "Enxergando através das mãos"

PURPOSE: The Project "Vision through the hands" was performed by the Altino Ventura Foundation, with the purpose of investigating the present child situation with multiple disabilities in the state of Pernambuco, Brazil. METHODS: Birth and social conditions, social problems, and difficulty in accessing the specialized services were evaluated, aiming to collect relevant data with the goal of posterior implantation of a specialized diagnosis and treatment center. Ophthalmologic care and proper treatment were offered. RESULTS: Three hundred and nine children from five reference institutions in disabilities were attended, on six non consecutive days. All cases underwent ophthalmologic examinations and parent interviews. During the waiting time between the ophthalmologic visits and parent interviews the patients performed activities with artists. A multidisciplinary team of 31 professionals was available. According to parent information 83.1% of the patients were considered included in the society and only 45.4% attended school (normal or special). The difficulty to get access to ophthalmologic service was reported by 51.1%. Two hundred and seventy children with multiple disabilities were identified, 154 (56.2%) of whom underwent an ophthalmologic examination for the first time, and 33.0% had low visual acuity (inferior to 20/60 Snellen). The most frequent diagnoses were: refraction error, strabismus, ambliopia, alterations of optic nerve (glaucoma and atrophy), and cataract. Eighty-four glasses were prescribed. CONCLUSION: This project was pioneer in the region, allowing to obtain the information about important problems regarding multiple disabilities, and making possible ophthalmologic care and specialized treatment to the children.

Experiência em projeto: "Enxergando através das mãos" / \"Vision through the hands\": experience of a project

OBJETIVO: A Fundação Altino Ventura realizou o projeto "Enxergando através das mãos", com o objetivo de investigar a situação atual da múltipla deficiência no estado de Pernambuco, verificar a demanda reprimida nesta área e analisar relevância para implantação de um centro especializado de referência para o diagnóstico e tratamento desses pacientes. MÉTODOS: Foi avaliado o perfil de um grupo de pacientes atendidos em cinco serviços de referência do grande Recife. Os casos foram avaliados quanto a ocorrências perinatais, inclusão social e dificuldades de acesso aos serviços especializados. Promoveu-se o atendimento oftalmológico especializado e o tratamento indicado para cada caso. O projeto foi desenvolvido de forma prospectiva, seguindo protocolo e organograma previamente elaborados. Os atendimentos foram realizados em seis dias não consecutivos, durante os quais todos os casos passavam pelas etapas de entrevista dos genitores e exame oftalmológico completo. Durante o período de espera entre entrevista e exame oftalmológico os pacientes realizavam atividades lúdicas com artistas plásticas. Contou-se com equipe multidisciplinar de 31 profissionais. RESULTADOS: Foram atendidos 309 pacientes. Estavam incluídos na sociedade 83,1 por cento dos pacientes, apenas 45,4 por cento freqüentavam escola (normal ou especial). A dificuldade de acesso aos serviços na área de oftalmologia foi relatada por 51,1 por cento dos casos. Foram identificadas 274 crianças com múltiplas deficiências, destas, 154 (56,2 por cento) nunca haviam sido examinadas pelo oftalmologista e 33 por cento tinham baixa de visão (inferior à 20/60 na tabela de Snellen). Os diagnósticos oftalmológicos mais freqüentes foram: erro refracional, estrabismo, ambliopia, alterações do nervo óptico (glaucoma e atrofia), e catarata. Foram prescritos e doados 84 óculos. CONCLUSÃO: O projeto foi pioneiro na região, permitindo a obtenção de importantes dados quanto à problemática da deficiência...

PURPOSE: The Project "Vision through the hands" was performed by the Altino Ventura Foundation, with the purpose of investigating the present child situation with multiple disabilities in the state of Pernambuco, Brazil. METHODS: Birth and social conditions, social problems, and difficulty in accessing the specialized services were evaluated, aiming to collect relevant data with the goal of posterior implantation of a specialized diagnosis and treatment center. Ophthalmologic care and proper treatment were offered. RESULTS: Three hundred and nine children from five reference institutions in disabilities were attended, on six non consecutive days. All cases underwent ophthalmologic examinations and parent interviews. During the waiting time between the ophthalmologic visits and parent interviews the patients performed activities with artists. A multidisciplinary team of 31 professionals was available. According to parent information 83.1 percent of the patients were considered included in the society and only 45.4 percent attended school (normal or special). The difficulty to get access to ophthalmologic service was reported by 51.1 percent. Two hundred and seventy children with multiple disabilities were indentified, 154 (56.2 percent) of whom underwent an ophthalmologic examination for the first time, and 33.0 percent had low visual acuity (inferior to 20/60 Snellen). The most frequent diagnoses were: refraction error, strabismus, ambliopia, alterations of optic nerve (glaucoma and atrophy), and cataract. Eighty-four glasses were prescribed. CONCLUSION: This project was pioneer in the region, allowing to obtain the information about important problems regarding multiple disabilities, and making possible ophthalmologic care and specialized treatment to the children.

Agravos peri-gestacionais em pacientes atendidos em centros de referência para deficientes do Recife e zona metropolitana / Gestacional insults in patients cared for at Referenc Centers for handicapped child in Recife and Metropolitan area

Foi objetivo deste estudo avaliar a possível relação da presença de agravos peri-gestacionais e a presença de múltiplas deficiências em pacientes atendidos em centros de referência do Recife e sua região metropolitana. Realizou-se um estudo observacional transversal com componente analítico, em 309 pacientes atendidos em centros de referência em reabilitação de deficiências do Recife e região metropolitana, no período de junho a setembro de 2004. Foi aplicado aos genitores dos pacientes um questionário estruturado quanto ao uso na gestação de medicações, chás, álcool, fumo, drogas; além de presença de infecções. Analisaram-se estes dados relacionando-os com a deficiência apresentada pelo paciente. O material coletado foi arquivado em banco de dados Excel. Foi utilizado o teste de qui-quadrado (x²), para avaliação de possíveis diferenças em frequências. Dos genitores entrevistados 274/309 (89,9our cento) eram responsáveis por portadores de múltipla deficiência identificaram-se algum insulto gestacional; farmacológico, infeccioso, álcool, tabaco ou drogas em 103/309 casos (33,3por cento). O uso de chás medicinais foi o mais comum 33/309 (10,6 por cento), sguido do uso de misoprostol 7/309 (2,2por cento). Os insultos infecciosos estavam presentes no período peri-gestacional em 10,0por cento das pacientes entrevistadas. Historia de aborto prévio foi relatado em 23,3por cento das genitoras. O uso de álcool e de tabaco na gravidez foram identificado em 50/309 (16,2por cento) e 48/309 (15,1por cento), respectivamente. Na amostra estudada o uso de substâncias abortivas e o aparecimento de deficiências não puderam ser estabelecidas, não se podendo apresentar dados conclusivos. O período perigestacional é muito frágil e susceptível a insultos, podendo ser vulnerável a diversos fatores, o que dificulta atribuição das deficiências encontradas a um único evento. Verificou-se elevada frequência de pacientes com paralisia cerebral, na grande maioria das vezes associada a hipóxia ou anóxia cerebral perinatal