Causes of functional low vision in a Brazilian rehabilitation service.

There is limited information on functional low vision (FLV) in Latin America, especially in individuals under 50 years of age. In the present study, we retrospectively evaluated the medical records of 1393 consecutive subjects seen at a Brazilian tertiary rehabilitation service, from February 2009 to June 2016. We collected sociodemographic, clinical data, and information on optical aids and spectacle prescription. Subjects were divided into three age groups: 0 to 14 years old (children), 15 to 49 years old (young adults), and 50 years or older (older adults). The main etiologies leading to FLV in children were cerebral visual impairment (27.9%), ocular toxoplasmosis (8.2%), and retinopathy of prematurity (7.8%). In young adults, retinitis pigmentosa (7.4%) and cone/rod dystrophy (6.5%) were the most frequent, while in older adults, age-related macular degeneration (25.3%) and diabetic retinopathy (18.0%) were the leading causes. Our results indicate that preventable diseases are important causes of FLV in children in the area, and proper prenatal care could reduce their burden. The increasing life expectancy in Latin America and the diabetes epidemic are likely to increase the demand for affordable, people-centered rehabilitation centers, and their integration into health services should be planned accordingly.

Efeito da desnutrição na cicatrização de anastomoses colônicas: estudo experimental em ratos / Effects of malnutrition on colonic anastomosis healing: an experimental study in rats

A deiscência de anastomose é uma das mais graves complicações advindas de operações do tubo gastrintestinal. Algumas condições gerais podem prejudicar o processo de cicatrização, tais como: desnutrição e hipoalbuminemia. Este estudo experimental teve como objetivo avaliar a cicatrização de anastomoses colônicas na vigência de desnutrição protéico-calórica e hipoalbuminemia. Dividimos os animais em dois grupos, sendo um deles o controle e o outro desnutrido (ingestão diária de metade da ração do grupo controle por vinte dias). O peso corporal, a albumina sérica, a evolução clínica, a cavidade abdominal, os aspectos macro e microscópicos da anastomose, a esteatose hepática e a concentração tecidual de hidroxiprolina foram observadas em cada animal. Pudemos notar que o método utilizado para desnutrir os animais mostrou-se eficaz, uma vez que houve redução significativa do peso do grupo experimental. Observamos que o grupo desnutrido apresentou dados necroscópicos de pior prognóstico e mortalidade superior ao grupo controle. Concluímos que a desnutrição influencia negativamente na cicatrização de anastomoses colônicas e aumenta significativamente a mortalidade.

Dehiscence of colonic anastomosis is one of the most severe complications after gastrointestinal surgery. The intestinal anastomosis healing complication is associated to several factors like malnutrition and hypoalbuminemia. This is an experimental study that aimed to evaluate the colonic anastomosis healing in malnutrition and hypoalbuminemia conditions. Animals were separated in two experimental groups: control and submitted to malnutrition (daily food intake as half of the control group per 20 days). Body weight, clinical outcome, serum albumin, abdominal cavity aspects, gross and microscopic aspects of the anastomosis, hepatic steatosis and tissue hydroxyproline dosage were compared between groups. Our results show that malnutrition development was efficient since a significant loss of body weight was observed in the experimental group. The malnutrition group of rats presented pathologic data all suggestive of lower prognostic and higher mortality rate. In conclusion, malnutrition interferes with the normal colonic anastomosis healing and increases the mortality rate.