Seizure occurring with retinal laser therapy: a report of the first case with frequency-doubled Nd-YAG / Convulsão durante laserterapia retiniana: relato do primeiro caso com o Nd-YAG de frequência dobrada

ABSTRACT Laser photocoagulation is a safe method for the treatment of retinal disorders. We present a case of a 21-year-old woman with high myopia, retinal detachment in the right eye, and bilateral lattice degeneration. She underwent surgical repair in the right eye followed by bilateral retinal laser therapy. During laser photocoagulation of the left eye, she experienced a generalized tonic-clonic seizure for the first time in her life. She had a positive family history of epilepsy. Neurological examination and brain magnetic resonance imaging findings were normal, but an electroencephalogram revealed epileptogenic discharges, more frequent during photostimulation. She avoided flickering lights during the 2-year follow-up, without seizure recurrence. Approximately 5% of patients with epilepsy have photosensitive epilepsy, of whom a considerable proportion will experience seizures only during exposition to flashing lights. Laser photocoagulation was already successfully employed in an animal model of photosensitive epilepsy. Personal or family history of photosensitivity warrants a neurological consultation before retinal treatment with laser therapy.

RESUMO Fotocoagulação a laser é método seguro para tratamento de retinopatias. Apresentamos o caso de uma mulher de 21 anos com alta miopia e degeneração lattice bilateral que sofreu descolamento de retina no olho direito e foi submetida a tratamento cirúrgico e ulterior laserterapia. Durante a fotocoagulação no olho esquerdo, ela teve uma convulsão tônico-clônica generalizada, a primeira em sua vida. Havia história familiar de epilepsia. O exame neurológico e a ressonância magnética de en céfalo foram normais, mas o electroencefalograma revelou descargas epileptogênicas, mais frequentes durante a fotoesti mulação. Ela evitou luzes piscantes durante os 2 anos subsequentes, sem recorrência de convulsões. Cerca de 5% dos pacientes com epilepsia têm fotossensibilidade. Proporção considerável deles terá convulsões somente durante exposição à luz piscante. Fotocoagulação a laser já foi empregada como modelo animal de sucesso para epilepsia fotossensível. Presença de fotossensibilidade na história pessoal ou familiar deve merecer avaliação neurológica antes do tratamento retiniano.

Seizure occurring with retinal laser therapy: a report of the first case with frequency-doubled Nd-YAG.

Laser photocoagulation is a safe method for the treatment of retinal disorders. We present a case of a 21-year-old woman with high myopia, retinal detachment in the right eye, and bilateral lattice degeneration. She underwent surgical repair in the right eye followed by bilateral retinal laser therapy. During laser photocoagulation of the left eye, she experienced a generalized tonic-clonic seizure for the first time in her life. She had a positive family history of epilepsy. Neurological examination and brain magnetic resonance imaging findings were normal, but an electroencephalogram revealed epileptogenic discharges, more frequent during photostimulation. She avoided flickering lights during the 2-year follow-up, without seizure recurrence. Approximately 5% of patients with epilepsy have photosensitive epilepsy, of whom a considerable proportion will experience seizures only during exposition to flashing lights. Laser photocoagulation was already successfully employed in an animal model of photosensitive epilepsy. Personal or family history of photosensitivity warrants a neurological consultation before retinal treatment with laser therapy.

Perfil epidemiológico da sífilis adquirida em município do interior do estado do Rio Grande do Sul / Epidemiological profile of acquired syphilis in a municipality in the interior of the state of Rio Grande do Sul

RESUMO Introdução: A sífilis é uma doença infecciosa, transmitida por via sexual. Tendo em vista o aumento da casuística de Sífilis nos últimos cinco anos e, em análises individuais, o destaque da região Sul do Brasil, a pesquisa visa fazer uma comparação entre a incidência de sífilis durante o período de 2015-2017 no município de Passo Fundo, Rio Grande do Sul, e estimar fatores de risco associados à incidência da patologia no município. Métodos: A metodologia usada será um estudo transversal retrospectivo a ser realizado no período de junho de 2018 à de setembro de 2018, compreendendo análise de dados a partir do sistema de notificação de doenças compulsórias do Data-SUS (Base de dados informatizada do Sistema Único de Saúde). Resultados: Ao todo, foram coletados dados de 1797 pacientes O perfil epidemiológico da sífilis, no município de Passo Fundo, do ano de 2015 à 2017, compôs-se de maioria do sexo masculino, entre 21 e 30 anos de idade, caucasianos, habitantes da zona urbana. Grande parte dos boletins de notificação não apresentou dados quanto à escolaridade da população estudada. Conclusões: Evidenciou-se um aumento de 91,71% dos casos notificados no município de Passo Fundo ao comparar-se números absolutos de notificação nos anos de 2015 e 2017. Ainda, demonstrou-se possível evidenciar população com vulnerabilidade maior para desenvolver a infecção por sífilis adquirida no município. PALAVRAS-CHAVE: Incidência, patologia, sífilis adquirida

ABSTRACT Introduction: Syphilis is a sexually transmitted infectious disease. Given the increase in the number of syphilis cases in the last five years and, in individual analyses, the highlight of the southern region of Brazil, the research aims to compare the incidence of syphilis during the period 2015-2017 in the municipality of Passo Fundo, Rio Grande do Sul, and to estimate risk factors associated with the incidence of the pathology in the city. Methods: The methodology used will be a retrospective cross-sectional study to be carried out from June 2018 to September 2018, comprising data analysis from the Data-SUS compulsory disease notification system (computerized database of the Brazilian National Health System). Results: In all, data from 1797 patients were collected. The epidemiological profile of syphilis in the city of Passo Fundo, from 2015 to 2017, consisted of mostly males, between 21 and 30 years of age, Caucasian, urban area residents. A large part of the notification reports did not include data about schooling of the studied population. Conclusions: An increase of 91.71% of reported cases in the municipality of Passo Fundo was evidenced when comparing absolute numbers of notifications in the years of 2015 and 2017. It was also demonstrated that there is a population with greater vulnerability to develop the infection by syphilis in the municipality. KEYWORDS: Incidence, pathology, acquired syphilis

Non-alcoholic fatty liver disease and associated risk factors in health care professionals in a community hospital in Brazil.

INTRODUCTION: Health care professionals are vulnerable to several health problems, including overweight, stress and anxiety. As such, non-alcoholic fatty liver disease is a likely diagnosis in this population. OBJECTIVES: To investigate the association between non-alcoholic fatty liver disease and levels of stress and anxiety in a sample of health care workers in a community hospital in the state of Rio Grande do Sul. METHODS: The sample consisted of 107 health care workers who were interviewed and screened for non-alcoholic fatty liver disease based on clinical, imaging and laboratory parameters. Occupational stress was evaluated using Lipp's Stress Symptom Inventory, and anxiety was assessed using the Hamilton Anxiety Rating Scale. RESULTS: The mean age of the sample was 37.6 years. Most participants were female (89.1%) and the most frequent occupation was nursing technicians (83.2%). While 77.22% of participants did not report significant levels of stress, 30.7% did have mild anxiety. Statistical tests did not reveal a significant association between non-alcoholic fatty liver disease and stress (p = 0.688) or anxiety (p = 0.996). CONCLUSIONS: All participants with non-alcoholic fatty liver disease had some degree of anxiety, but only some experienced stress symptoms, according to Lipp's Inventory. Statistical tests did not confirm an association between stress, anxiety and the presence non-alcoholic fatty liver disease. Nevertheless, the potential association between these variables should continue to be investigated given the global rise in the prevalence of non-alcoholic fatty liver disease and its implications for health care workers.