Graves' orbitopathy: frequency of ocular hypertension and glaucoma.

PURPOSE: To determine the relationship between ocular hypertension and glaucoma in patients with Graves' orbitopathy. METHODS: A total of 107 patients with a diagnosis of Graves' orbitopathy, followed at the Oculoplasty sector of the University Hospital, Medical School of Ribeirão Preto, were evaluated by applanation tonometry, computed visual campimetry (Humphrey 30-2, Full Threshold) and analysis and photographic documentation of the optic nerve. The patients considered to have the suspicion of glaucoma were re-evaluated 1 year later for diagnostic confirmation or exclusion. RESULTS: A 3.74% prevalence of ocular hypertension (four patients) and a 2.8% prevalence of glaucoma (three patients) was observed. When considering only patients older than 40 years, the prevalence of ocular hypertension was 5.4% (four patients) and the prevalence of glaucoma was 4.76% (three patients). CONCLUSION: The present study did not reveal a statistically significant difference in the prevalence of ocular hypertension or glaucoma between patients with Graves' orbitopathy and the general population.

Neonatal orbital abscess.

PURPOSE: To describe two cases of orbital abscess in neonates and to review the literature of orbital cellulitis in neonates. DESIGN: Two interventional case reports. METHODS: Photographs, orbital computed tomography scans, and full pediatric examination were obtained in two cases of orbital abscess in neonates. RESULTS: Acute ethmoiditis with orbital abscess formation was found in both infants. In one of them, Staphylococcus aureus was identified as the source of infection. CONCLUSIONS: The clinical findings of our cases concur with the literature (eight cases) indicating that orbital abscess caused by Staphylococcal ethmoiditis is the most common form of orbital cellulitis in neonates.

Histologic effect of mitomycin C on strabismus surgery in the rabbit.

PURPOSE: To evaluate the efficiency of mitomycin C (MMC) in limiting the postoperative inflammatory response and scarring after strabismus surgery. METHODS: A prospective, two-stage, masked, controlled trial was conducted. In the first stage, the inflammatory response at the extraocular muscle reattachment site was increased after inferior rectus recession in eight rabbits. In the second stage, MMC (0.4 mg/ml) was applied during surgery to the eyes of 22 rabbits with inferior rectus recession. As a control, contralateral eyes were treated with saline solution. Seven weeks later, exenteration was performed, and the sites of muscle reattachment were processed for histologic examinations. The sums of the areas of the granulomas in the extraocular muscle reattachment sites of control and treated eyes were compared. RESULTS: There was no significant inhibitory effect of MMC on the inflammatory response of treated eyes compared with that of control eyes. CONCLUSIONS: The intraoperative use of MMC (0.4 mg/ml) was not effective in controlling the postoperative inflammatory response in rabbit eyes after extraocular muscle surgery. These data do not support the hypothesis that MMC reduces postoperative adhesions after strabismus surgery.

Monitoria Acadêmica em Semiologia Médica: Descrição e Avaliação de uma Nova Experiência

Resumo: O presente artigo refala uma nova experiência de metodologia de ensino -aprendizagem descritas pelos próprios monitores, desenvolvida no curso de Medicina da Universidade Estadual de Londrina, junto à disciplina de Semiologia. Esta monitoria acadêmica caracterizou-se pelas seguintes inovações: 1) Autonomia do monitor na elaboração do programa de atividades e, 2) Avaliação concomitante do método, através de questionários elaborados pelos monitores, aplicados periodicamente com o objetivo de identificar e caracterizar os principais fatores, prejudiciais e/ou benéficos, a fim de otimizar tal atividade acadêmica. Os autores descrevem o processo de seleção dos monitores, atividades desenvolvidas, dificuldades encontradas, resultados obtidos, e concluem que a modalidade de ensino com a utilização de monitores, mostra-se de extrema utilidade e importância no processo de formação médica, propiciando a transmissão de conhecimentos, aquisição de raciocínio crítico e estímulo à futura carreira universitária.

Summary: This article describes a new experiences of teaching methodology developed by the Medical Anamnesis and Physical Diagnosis at the School of Medicine of Universidade Estadual de Londrina. This academic teaching methodology was caracterized by: 1) The independence of the monitors to determinate the schedule of the activities and, 2) Continuous evaluation of the method, applied periodically to identify the major problems in order to improve the teaching method. The authors describe the selecting process of the monitors, activities carried out, unexpected difficulties, results anel conclude that· the proposed methodology is extremely useful in Medical Education and play an important role in improving knowledge, reasoning and stimulating a future University carrier.