Severe traumatic brain injury and acute kidney injury patients: factors associated with in-hospital mortality and unfavorable outcomes.

OBJECTIVE: The purpose of this study was to identify the occurrence of AKI, and factors associated with in-hospital mortality and unfavorable outcomes in patients with severe traumatic brain injury (TBI) and acute kidney injury (AKI) severity. METHOD: A retrospective cohort study which analyzed data with severe TBI between 2013 and 2017. We examined demographic and clinical information, and outcome by in-hospital mortality, and the Glasgow Outcome Scale six months after TBI. We associated factors to in-hospital mortality and unfavorable outcome in severe TBI and AKI with an association test. RESULTS: A total of 219 patients were selected, 39.3% had an AKI, and several factors associated with AKI occurrence after severe TBI. Stage 2 or 3 of AKI (OR 12.489; 95% CI = 4.45-37.94) were independent risk for both outcomes in multivariable models, severity injury by the New Trauma Injury Severity Score (OR 0.97; 95% CI = 0.96-0.99) for mortality, and the New Injury Severity Score (OR1.07; 95% CI = 1.04-1.10) and Trauma and Injury Severity Score (OR = 0.98; 95% CI = 0.965-0.997) for unfavorable outcome. CONCLUSION: The findings of our study confirmed that AKI severity and severity of injury was also related to increased mortality and unfavorable outcome after severe TBI.

Thermosensitive polymer-assisted extraction and purification of fungal laccase from citrus pulp wash effluent.

BACKGROUND: This study explores the use of liquid-liquid extraction with thermosensitive polymers for producing laccase (Lac) from Pleurotus sajor-caju. This process leverages liquid waste from the citrus industry, specifically pulp wash. The research delves into extractive fermentation and thermoseparation, both processes being facilitated by a polymer exhibiting a lower critical solution temperature transition. RESULTS: Key factors considered include the choice of polymer, its concentration, pH, separation temperature, and the behavior of the polymer-rich phase post-extractive fermentation concerning the lower critical solution temperature. Notably, under conditions of 45% by weight of Pluronic L-61 and pH 5.0 at 25 °C, the Lac resulted in an enhancement in the purification factor of 28.4-fold, compared with the Lac obtained directly from the fermentation process on the eighth day. There was an 83.6% recovery of the Lac enzyme in the bottom phase of the system. Additionally, the unique properties of Pluronic L-61, which can induce phase separation and also allow for thermoseparation, led to a secondary fraction (aqueous solution) of Lac with purification factor of 2.1 ± 0.1-fold (at 32 ± 0.9 °C and 30 ± 0.3 min without stirring) from the polymeric phase (top phase). Fourier-transform infrared analysis validated the separation data, particularly highlighting the α-helix content in the amide I region (1600-1700 cm-1 ). CONCLUSION: In summary, the insights from this study pave the way for broader industrial applications of these techniques, underscoring benefits like streamlined process integration, heightened selectivity, and superior separation efficacy. © 2023 Society of Chemical Industry.

Cardiac Manifestations Associated With Coronavirus Disease: A Case Report

Abstract This study presents a 47-year-old female patient, with a history of diabetes, who contracted SARS-CoV-2 and exhibited cardiovascular complications.

Encontro e acolhimento em territórios vivos: narrativas para repensar tecnologias de cuidado a pessoas em crise na atenção psicossocial / Meeting and welcoming in living territories: narratives to rethink care technologies for people in crisis in psychosocial care

Após um longo e acidentado percurso, perfilado pelas repercussões de um período pandêmico (uma situação de crise planetária), coloca-se à disposição essa coletânea de escritos produzidos a partir do convite para compartilhar experiências de atenção a pessoas em situação de crise, na perspectiva da Atenção Psicossocial, em territórios do semiárido nordestino, mais especificamente, no Vale do Médio São Francisco. Este livreto, chamado assim por intuito afetivo e jamais por uma avaliação de sua qualidade ou mesmo tamanho, ganhou um nome que busca expressar seu eixo de sustentação: a (re)afirmação da potência do encontro para produzir caminhos de abertura e de expansão de vida na produção do cuidado ­ Encontro e acolhimento em territórios vivos: narrativas para repensar tecnologias de cuidado a pessoas em crise na Atenção Psicossocial. Trata-se de uma produção coletiva, visceralmente polifônica, germinada a partir do desejo compartilhado de fazer circular outras narrativas e vozes em torno do cuidado a pessoas em situação de crise. Assume-se como um fruto de agenciamentos coletivos diversos, em um país em que as atualizações da colonização sofrida (e jamais devidamente reparada) são vívidas, inclusive nos modos de pensar e produzir saúde. Destaca-se, assim, sua intencionalidade de contribuir para reposicionar ou mesmo extrapolar a captura do campo da saúde pela racionalidade biomédica, reconhecendo seus limites e efeitos iatrogênicos, especialmente em um contexto contemporâneo, marcado brutalmente pela medicalização da vida. Como destacado por Sandra Fagundes, no prefácio do livreto: "No correr dos contos, como no Grande Sertão Veredas, de Guimaraes Rosa, a vida embrulha tudo. A vida é assim, esquenta e esfria, aperta e daí afrouxa, sossega e depois desinquieta. O que ela quer da gente é coragem. O cuidado em liberdade, o que requer é ancoragem: suporte para o insuportável, impensável, indizível e para a potência".

Evidence of Validity and Normative Values of a New Auditory Backward Masking Test.

There are still no valid, clinically feasible instruments to assess backward masking (BM), an auditory temporal processing (ATP) phenomenon. The aim of this study was to develop, standardize and present evidence of validity for a behavioral test for BM assessment. Young adults were submitted to a BM test (BMT), where they were asked to identify a 1000 Hz pure tone followed by a narrowband noise with interstimulus intervals of 0 to 400 ms and signal-to-noise ratio (SNR) between -20 and -30 dB. The correct response rate and target sound detection threshold were calculated, and the results compared with those of young adults with abnormal ATP tests and older adults. Diagnostic accuracy analyses were carried out. Young adults with normal ATP obtained an average correct response rate of 89 and 87% for SNR -20 and -30 dB, respectively, with average thresholds between 10 and 15 ms and no difference between the left and right ears. Results were more consistent at SNR -20 dB, and the best diagnostic accuracy was obtained for SNR -20 dB, with good specificity, but low sensitivity. Normative values were obtained for the BMT, which proved to be clinically feasible, with preliminary evidence of validity.

Exploring the Links between Obesity and Psoriasis: A Comprehensive Review.

Obesity is a major public health issue worldwide since it is associated with the development of chronic comorbidities such as type 2 diabetes, dyslipidemias, atherosclerosis, some cancer forms and skin diseases, including psoriasis. Scientific evidence has indicated that the possible link between obesity and psoriasis may be multifactorial, highlighting dietary habits, lifestyle, certain genetic factors and the microbiome as leading factors in the progress of both pathologies because they are associated with a chronic pro-inflammatory state. Thus, inflammation management in obesity is a plausible target for psoriasis, not only because of the sick adipose tissue secretome profile but also due to the relationship of obesity with the rest of the immune derangements associated with psoriasis initiation and maintenance. Hence, this review will provide a general and molecular overview of the relationship between both pathologies and present recent therapeutic advances in treating this problem.

Educational intervention through a comic book for preoperative anxiety in children, adolescents, and their parents: A randomized clinical trial.

BACKGROUND: Reducing preoperative anxiety can help optimize surgical care. AIM: To analyze the effectiveness of verbal guidance by nurses versus verbal guidance combined with a comic book on preoperative anxiety in children and their parents. METHODS: We conducted a randomized parallel, two-group controlled clinical trial in the pediatric ward and a blinded anxiety assessment in the operating room of a Brazilian hospital. Individuals aged 6-14 years undergoing surgical procedures of up to 4 h for the first time were included in the study. Parents who were adults, literate, and able to communicate verbally were included. The primary outcome was the children's anxiety, measured by the Children Anxiety Questionnaire (CAQ), Visual Analog Scale (VAS), and the modified Yale Preoperative Anxiety Scale (mYPAS); the secondary outcome was the parents' anxiety, assessed by the Hamilton Anxiety Rating Scale. Participants were divided into the intervention (IG; n = 60) and control (CG; n = 60) groups. FINDINGS: The two groups were homogeneous. The median age of the children was 8 years. No significant differences were observed in the CAQ and VAS scores between the two assessment time points or in the mYPAS scores between the IG and CG. However, parents' anxiety significantly decreased in both groups. APPLICATION TO PRACTICE: Preoperative guidance by nurses, either verbal only or verbal information with a comic book proved beneficial in reducing parental anxiety. However, both interventions, performed on the day of surgery, failed to reduce preoperative anxiety in children and adolescents upon admission to the operating room. We recommended the process of preparing the child should begin after scheduling the surgery.

Applications of Photodynamic Therapy in Endometrial Diseases.

Photodynamic therapy (PDT) is a medical procedure useful for several benign conditions (such as wound healing and infections) and cancer. PDT is minimally invasive, presents few side effects, good scaring, and is able to minimal tissue destruction maintaining organ anatomy and function. Endoscopic access to the uterus puts PDT in the spotlight for endometrial disease treatment. This work systematically reviews the current evidence of PDT's potential and usefulness in endometrial diseases. Thus, this narrative review focused on PDT applications for endometrial disease, including reports regarding in vitro, ex vivo, animal, and clinical studies. Cell lines and primary samples were used as in vitro models of cancer, adenomyosis and endometrioses, while most animal studies focused the PDT outcomes on endometrial ablation. A few clinical attempts are known using PDT for endometrial ablation and cancer lesions. This review emphasises PDT as a promising field of research. This therapeutic approach has the potential to become an effective conservative treatment method for endometrial benign and malignant lesions. Further investigations with improved photosensitisers are highly expected.

Medicinal plant use in primary health care: an integrative review. / O uso de plantas medicinais na atenção primária à saúde: revisão integrativa.

Medicinal plant (MP) use supports comprehensiveness of care in Primary Health Care (PHC), enabling appreciation of popular knowledge and self-care. This integrative literature review aims to analyze researches that approach the insertion of using MP in PHC. PICO strategy was used as a guideline in search of evidence, reuniting 18 articles published between January 2015 and August 2020, in the Virtual Health Library and PubMed databases. The variables of analysis were knowledge of PHC healthcare professionals about MP and associated policies, MP use by its users, highlighting their profile, the reasons that lead to the use and lack of security in MP use. The results show insufficient knowledge of healthcare professionals about Integrative and Complementary Practices policies and the medicinal uses of plants. The main users are women, elderly, with low income and education, either in Brazil or other countries. Regarding safety in MP use, frequently there is no correct identification of species, its origin, its preparation and the appropriate dose for each case. Finally, failure to approach these contents during training of healthcare professionals generates less knowledge, less research and more prejudice due to lack of information, impairing incentive and dissemination to the community.

O uso de plantas medicinais (PM) favorece a integralidade do cuidado na atenção primária à saúde (APS), valorizando o saber popular e o autocuidado. Esta revisão integrativa de literatura objetiva analisar estudos sobre a inserção do uso de PM na APS. A estratégia PICO norteou a busca de evidências, reunindo 18 artigos publicados de janeiro de 2015 a agosto de 2020 nos bancos de dados Biblioteca Virtual de Saúde e PubMed. As variáveis de análise foram o conhecimento dos profissionais da saúde da APS sobre PM e políticas associadas, o uso de PM pelos usuários, destacando seu perfil, fatores que favorecem o uso e a falta de segurança no uso de PM. A literatura aponta insuficiência de conhecimento dos profissionais de saúde sobre as políticas de práticas integrativas e complementares e o uso de plantas para fins medicinais. Os principais usuários são mulheres, idosas, com baixa renda e escolaridade, tanto no Brasil quanto em outros países. Sobre a segurança no uso de PM, frequentemente não há correta identificação de espécie, origem, preparo e dose adequada para cada caso. Por fim, a não abordagem desses conteúdos durante a formação de profissionais da saúde gera menos conhecimento, menos pesquisas e mais preconceito por falta de informação, prejudicando o incentivo e divulgação à comunidade.

O uso de plantas medicinais na atenção primária à saúde: revisão integrativa / Medicinal plant use in primary health care: an integrative review

Resumo O uso de plantas medicinais (PM) favorece a integralidade do cuidado na atenção primária à saúde (APS), valorizando o saber popular e o autocuidado. Esta revisão integrativa de literatura objetiva analisar estudos sobre a inserção do uso de PM na APS. A estratégia PICO norteou a busca de evidências, reunindo 18 artigos publicados de janeiro de 2015 a agosto de 2020 nos bancos de dados Biblioteca Virtual de Saúde e PubMed. As variáveis de análise foram o conhecimento dos profissionais da saúde da APS sobre PM e políticas associadas, o uso de PM pelos usuários, destacando seu perfil, fatores que favorecem o uso e a falta de segurança no uso de PM. A literatura aponta insuficiência de conhecimento dos profissionais de saúde sobre as políticas de práticas integrativas e complementares e o uso de plantas para fins medicinais. Os principais usuários são mulheres, idosas, com baixa renda e escolaridade, tanto no Brasil quanto em outros países. Sobre a segurança no uso de PM, frequentemente não há correta identificação de espécie, origem, preparo e dose adequada para cada caso. Por fim, a não abordagem desses conteúdos durante a formação de profissionais da saúde gera menos conhecimento, menos pesquisas e mais preconceito por falta de informação, prejudicando o incentivo e divulgação à comunidade.

Abstract Medicinal plant (MP) use supports comprehensiveness of care in Primary Health Care (PHC), enabling appreciation of popular knowledge and self-care. This integrative literature review aims to analyze researches that approach the insertion of using MP in PHC. PICO strategy was used as a guideline in search of evidence, reuniting 18 articles published between January 2015 and August 2020, in the Virtual Health Library and PubMed databases. The variables of analysis were knowledge of PHC healthcare professionals about MP and associated policies, MP use by its users, highlighting their profile, the reasons that lead to the use and lack of security in MP use. The results show insufficient knowledge of healthcare professionals about Integrative and Complementary Practices policies and the medicinal uses of plants. The main users are women, elderly, with low income and education, either in Brazil or other countries. Regarding safety in MP use, frequently there is no correct identification of species, its origin, its preparation and the appropriate dose for each case. Finally, failure to approach these contents during training of healthcare professionals generates less knowledge, less research and more prejudice due to lack of information, impairing incentive and dissemination to the community.

Update of Argentina's Regulatory Policies on the Environmental Risk Assessment.

The Environmental Risk Assessment (ERA) of genetically modified (GM) crops in Argentina is carried out by the National Advisory Commission on Agricultural Biotechnology (CONABIA) and the Innovation and Biotechnology Coordination (CIyB). Both have a large experience with this assessment, since 1991, when CONABIA was created. The continuous support to biotechnology as a state policy and as part of the decision to encourage developers in the regulatory process has helped make progress in the revision of the regulations. The experience gained during the last 30 years and the worldwide scientific advances supported the bases to update the regulatory framework. Focusing on the biosafety strengthening and the improvement of the applicant's experience in the GM crops evaluation process, during 2020 and 2021, the ERA went through a reviewing process. Some important modifications were made, such as (i) the assessment of stacked GM crops with focus on the possible interactions between transgenes and the expression products, (ii) the strengthening of the ERA taking into account the transportability of data and conclusions from the Confined Field Trials (CFTs), (iii) the adoption of Familiarity and History of Safe Use (HOSU) concepts on the risk assessment of the expression products, (iv) the special considerations for the unintended effects of insertional sites, and (v) as a post commercial release of GM crops, the Insect Resistance Management Plan (IRMP) was reformulated. These novel approaches enhance the ERA; they make it more efficient by applying the science criteria and the accumulated experience and scientific bibliography on the topic.

Uso de drogas e cuidado ofertado na Raps: o que pensa quem usa? / Drug abuse and care offer in the Psychosocial Care Network: what does the user think?

RESUMO O estudo pretendeu compreender como usuários do Centro de Atenção Psicossocial, Álcool e Drogas (Caps AD III) de Petrolina (PE), com experiência de internação em comunidades terapêuticas, avaliam as propostas terapêuticas desses dois tipos de dispositivos. Para tanto, buscou-se conhecer suas experiências de cuidado e analisar as possíveis convergências e divergências quanto às ofertas terapêuticas, valorizando-se seus pontos de vista. Tratando-se de pesquisa qualitativa, com intuito avaliativo, a entrada em campo ocorreu na perspectiva da cartografia, recorrendo-se à ferramenta usuário-guia, com definição de dois interlocutores, além da escrita de diários cartográficos. Os resultados foram circunscritos com respaldo na metodologia de relatos orais, destacando-se cinco eixos interpretativos: 1. compreensões sobre lógica de cuidado na perspectiva de usuários; 2. burocratização e protocolização da produção de cuidado; 3. medicalização nos dispositivos de cuidado; 4. cuidado versus controle; e 5. uso de substâncias psicoativas e questões de gênero. Visando contribuir para a análise do impacto da Política Nacional de Saúde Mental em dispositivos da Rede de Atenção Psicossocial no semiárido nordestino, o estudo visibilizou a importância de processos avaliativos permanentes, com ênfase no protagonismo de usuários/as, apresentando efeitos do processo de Reforma Psiquiátrica na região e caminhos possíveis para seu fortalecimento.

ABSTRACT The study aimed to comprehend how users of a Psychosocial Care Center - Alcohol and Drugs (Caps AD III) in the city of Petrolina (PE), also having experienced hospitalization in therapeutic communities, evaluate the therapeutic proposals of the two types of service. Therefore, their care experiences were taken for analysis, valuing their points of view and considering the possible convergences and divergences between the therapeutic offers. It was a qualitative research, with evaluative purpose. The fieldwork occurred from the perspective of cartography, using the user-guide tool, with the definition of two interlocutors. Data analysis was supported by the methodology of oral reports, indicating five interpretative axes: 1. users' comprehension of the care logic; 2. bureaucratic and protocolized production of care; 3. medicalization in care devices; 4. care versus control practices; and 5. drug abuse and gender issues. In order to contribute to the analysis of the impact of the National Mental Health Policy on devices of the Psychosocial Care Network in the northeastern semiarid, the study showed the importance of permanent evaluation processes, emphasizing the role of users, presenting effects of the Psychiatric Reform process and possible ways to strengthen it.

Equipe multiprofissional no preparo para a alta hospitalar de crianças com condições crônicas / Multi-professional team in hospital discharge of children and adolescents with chronic conditions

Objective: to know the preparation for hospital discharge carried out by the multi-professional health team for children with chronic conditions and their families. Method: qualitative, exploratory-descriptive research carried out between November 2018 and March 2019 through semi-structured interviews with ten professionals from the multidisciplinary health team at the Pediatric Clinic of a hospital in Paraíba. The interviews were submitted to Minayo's Thematic Analysis. Results: the preparation for hospital discharge is complex and suffers several influences from the dynamics of the service. We observed that it is difficult to include integrated actions in the preparation for discharge during the daily care of the multi-professional team. During this process, the importance of including the child in care is highlighted, emphasizing the need for self-perception about their current health situation, as well as the possibility of carrying out self-care, depending on their age, understanding, and risks when performing the procedure. Final considerations: there are several weaknesses in the implementation of the preparation for hospital discharge in the pediatric clinic, such as the lack of a protocol or standard that guides this process, carrying out disjointed and individualized interventions inherent to each professional training, hindering the family's effective learning process, compromising the safe return home.

Objetivo: Conhecer o preparo para alta hospitalar realizado pela equipe multiprofissional de saúde a crianças com condições crônicas e seus familiares. Método: Pesquisa qualitativa, exploratória-descritiva, realizada entre novembro de 2018 e março de 2019por meio de entrevista semiestruturada com dez profissionais da equipe multiprofissional de saúde da Clínica Pediátrica de um hospital da Paraíba. As entrevistas foram submetidas à Análise Temática de Minayo. Resultados: O preparo para a alta hospitalar é complexo e sofre diversas influências da dinâmica do serviço. Evidenciou-se dificuldade de inclusão de ações integradas no preparo para alta durante a assistência cotidiana da equipe multiprofissional. Durante esse processo, destaca-se a importância da inclusão da criança nos cuidados, ressaltando a necessidade da autopercepção sobre sua situação atual de saúde, assim como a possibilidade de realizar o autocuidado, a depender da sua idade, compreensão e dos riscos ao realizar o procedimento. Considerações finais: Há diversas fragilidades na implementação do preparo para a alta hospitalar na clínica pediátrica, como a inexistência de protocolo ou norma que balize esse processo, realização de intervenções desarticuladas e individualizadas inerentes a cada formação profissional, dificultando o processo de aprendizagem efetivo da família, comprometendo o retorno ao domicílio com segurança.

Epidemiological Profile of the Contact Lens Sector of the Benjamin Constant Institute in Rio de Janeiro / Perfil Epidemiológico do Setor de Lentes de Contato do Instituto Benjamin Constant do Rio de Janeiro

Abstract Objective: The objective of this project is to describe the epidemiological profile of the Contact Lens Sector of the Benjamin Constant Institute in Rio de Janeiro. Methods: A retrospective study of 788 cases was carried out from March / 2004 to June / 2015. Results: Most of the objects in the cases were female (62.23%). As for the indication, 445 cases (56.47%) were optical, 281 cases (35.65%) were esthetic, 44 cases (5.58%) were prosthetic, and 18 cases (2.30%) were cosmetic. The most prevalent age group was from 20-39 years of age (46.34% of cases), followed by 40-64 years of age (25.31% of cases). Of the total of adapted cases, 81.6% were with rigid lenses, and among the optical medical indications, 61.4% of the cases were by keratoconus. Conclusions: Because it is a reference medical service, whose main objective is the rehabilitation of patients with low vision, the optical medical indication was the most frequent. The rigid lenses showed up with a prominent role in the adaptations.

Resumo Objetivo: Descrever as estatísticas do Setor de Lente de Contato do Instituto Benjamin Constant do Rio de Janeiro. Métodos: Estudo retrospectivo de 794 casos no período de março/2004 a junho/2015. Resultados: A maior parte dos casos foi do sexo feminino (62,21%) e a indicação mais frequente foi médicas ópticas (56,04%). A faixa etária mais prevalente foi a de 20-39 anos, correspondendo a 46,34%, e em seguida a de 40-64 anos (25,31%). Do total de casos adaptados, 81,6% foram com lentes rígidas. Entre as indicações médicas ópticas 61,4% dos casos foram por ceratocone. Conclusões: Por ser tratar em um serviço médico de referencia, cujo principal objetivo é a reabilitação de pacientes com visão subnormal, a indicação médica óptica foi a mais frequente. As lentes rígidas mostraram-se com papel de destaque nas adaptações.

Oftalmomiíase externa / External ophthalmomyiasis

RESUMO O objetivo deste resumo é relatar um caso de portador de oftalmomiíase externa, discorrendo sobre o quadro clínico, os diagnósticos diferenciais e as opções de tratamento. As informações foram obtidas por meio de revisão do prontuário, entrevista com o paciente e registro fotográfico dos métodos diagnósticos e terapêuticos aos quais o paciente foi submetido. Dados foram analisados junto a uma extensa revisão da literatura. O nosso artigo relata um caso de um paciente que foi inicialmente diagnosticado e tratado como celulite pré -septal e após avaliação de especialista em oculoplástica foi realizado o diagnóstico e tratamento adequado para oftalmomiíase. Também revela a importância deste diagnóstico, infrequente nos grandes centros urbanos, seu tratamento e evolução.

ABSTRACT The purpose of this report is to describe a case of external ophthalmomyiasis, discussing the clinical picture, differential diagnoses and treatment options. The information was obtained by means of a review of the medical record, an interview with the patient and a photographic record of the diagnostic and therapeutic methods to which the patient was submitted. Data were analyzed together with an extensive review of the literature. Our article reports a case of a patient who was initially diagnosed and treated for pre-septal cellulitis and after evaluation by a specialist in oculoplastics, the diagnosis and appropriate treatment for ophthalmomyiasis was performed. It also reveals the importance of this diagnosis, infrequent in large urban centers, its treatment and evolution.

Perfil epidemiológico das aplicações intravítreas de Ranibizumab / Epidemiological profile of Ranibizumab intravitreal applications

Resumo Objetivo: O objetivo desse trabalho é avaliar o perfil de aplicações intravítreas do Ranibizumab em uma população de adultos atendidos no Instituto Benjamin Constant, no ano de 2015, levando em consideração o efeito sobre a acuidade visual e a espessura macular após tratamento. O objetivo secundário é apresentar as principais indicações desse tipo tratamento no serviço de olhos acima citado. Métodos: Foi realizado um estudo retrospectivo seccional, em indivíduos acima de 20 anos entre os meses de março a agosto de 2015, para analisar a acuidade visual e espessura foveal pré e pós tratamento. A dose do anti-VEGF utilizada foi de 0,05ml por aplicação com intervalo de quatro semanas entre elas. A aferição da acuidade visual assim como o OCT pós tratamento foram realizados em torno de trinta dias após a última aplicação. As análises estatísticas foram feitas com uso do software SPSS versão 21 e o nível de significância estatística foi de 95% com um valor de p <0,05. Resultado: O estudo mostrou que a principal afecção relacionada a esse tratamento foi a retinopatia diabética não proliferativa associada ao edema macular (32,8%). Após o tratamento indicado com Ranibizumab, houve uma melhora da acuidade visual média de 0,70 para 0,59 (logMAR) e uma regressão da espessura macular, visto no OCT, de 408,1µm para 337,2 µm (valor de p <0,05). Conclusão: Pode-se concluir portanto, que o tratamento com Ranibizumab na população estudada contribuiu para uma melhor qualidade de vida dos pacientes, pois a maioria dele apresentou uma melhora estatisticamente significativa na acuidade visual após as aplicações.

Abstract The objective of this work is to evaluate the profile of intravitreal applications of Ranibizumab in a population of adults attended at the Benjamin Constant Institute in the year of 2015, taking into account the effect on visual acuity and macular thickness after the treatment. The secondary objective is to present the main indications of this type of treatment in the eye care mentioned above. A retrospective cross-sectional study was performed in individuals over 20 years of age between March and August of 2015 to analyze visual acuity and foveal thickness before and after treatment. The dose of anti-VEGF used was 0.05 ml per application with an interval of four weeks between them. Visual acuity assessment as well as OCT post treatment were performed around 30 days after the last application. Statistical analyses were performed using SPSS software version 21 and the level of statistical significance was of 95% with a value of p <0.05. The study showed that the main condition related to this treatment was non-proliferative diabetic retinopathy associated with macular edema (32.8%). After treatment indicated with Ranibizumab, there was an improvement in the average visual acuity from 0.70 to 0.59 (logMAR) and a regression of the macular thickness, seen in the OCT, from 408.1μm to 337.2μm (p < 0.05). It can be concluded, therefore, that treatment with Ranibizumab in the studied population contributed to a better quality of life of the patients, since most of them presented a statistically significant improvement in the visual acuity after the applications.

Avaliação da melhora da acuidade visual após adaptação de lentes de contato em pacientes portadores de ceratocone / Evaluation of visual acuity improvement after adaptation of contact lenses in patients with keratoconus

Resumo Objetivo: Avaliar a eficácia na adaptação de lentes de contato em relação à melhora da acuidade visual em pacientes portadores de ceratocone. Métodos: Foi realizado um estudo retrospectivo, através de revisão de prontuários médicos, em 175 pacientes (326 olhos) portadores de ceratocone, atendidos no período de março/2004 a junho/2015. Foram coletados os dados sobre sexo, idade, número de olhos adaptados, severidade do ceratocone e acuidade visual com óculos e com lentes de contato. Resultados: Dos pacientes avaliados, 100 pacientes (57,4%) eram do sexo feminino e 75 pacientes (42,6%) do sexo masculino. Dos olhos classificados, 267 (81,9%) tinham ceratocone moderado (45 a 52D). A faixa etária mais frequente foi de 10-39 anos (84%) e a taxa de sucesso ao fim do tratamento foi de 92,3% (acuidade visual boa ou satisfatória). Conclusão: A adaptação de lentes de contato mostrou-se eficaz em proporcionar importante melhora da acuidade visual em pacientes portadores de ceratocone.

Abstract Objective: To evaluate the efficiency of the contact lens adaptation in relation to the improvement of visual acuity in patients with keratoconus. Methods: A retrospective study of 175 patients (326 eyes) with keratoconus was carried out from March 2004 to June 2015. Data on sex, age, number of adapted eyes, keratoconus severity, and visual acuity with glasses and contact lenses were collected. Results: Of the classified eyes, 267 (81.9%) had moderate keratoconus (45 to 52D). The most frequent age group was 10-39 years of age (84%) and the success rate at the end of treatment was 92.3% (good or satisfactory visual acuity). Conclusion: Adaptation of contact lenses was effective in providing important improvement of visual acuity in patients with keratoconus.

Phenotypic expression variability in Best Disease: a purpose of a series of cases / Variabilidade de expressão Fenotípica na Doença de Best: a propósito de uma série de casos

Abstract The objective of the following work is to document the phenotypic expression variability in Best Disease in first-degree relatives. The information was collected by assessing medical notes, interviewing the patient and obtaining photographic record of the diagnostic methods to which the patient was submitted. Data was analyzed along with a thorough review of the literature. A series of cases were reported in which the patient presenting the phenotypic characteristics of the disease has first degree relatives without ophthalmic findings during examination, but present an abnormal pattern on the electro-oculogram (EOG). Our article reveals the importance of electrophysiological exams in the diagnosis of Best vitelliform macular dystrophy, including the prevention of its clinical manifestation (autosomal dominant), providing concrete subsidies for genetic counseling.

Resumo O objetivo do presente trabalho é a documentação da variabilidade de expressão fenotípica da Doença de Best em parentes de primeiro grau. As informações foram obtidas por meio de revisão do prontuário, entrevista com o paciente e registro fotográfico dos métodos diagnósticos aos quais os pacientes foram submetidos. Dados foram analisados junto a uma extensa revisão da literatura. Relatamos uma série de casos, no qual o paciente que apresenta as alterações fenotípicas da doença tem familiares de primeiro grau sem alterações ao exame oftalmológico, porém os mesmos apresentam padrão anormal de eletro-oculograma (EOG). O nosso artigo revela a importância dos exames eletrofisiológicos no diagnóstico da distrofia macular viteliforme de Best, inclusive no que se refere à prevenção de sua manifestação clínica (autossômica dominante), fornecendo subsídios concretos para o aconselhamento genético.