Congenital simple hamartoma of the retinal pigment epithelium: a case report.

We report the case of a 56-year-old woman who presented for a routine ophthalmological examination without visual symptoms and had a unilateral black retinal lesion that was detected by clinical examination. Fluorescein angiography and optical coherence tomography findings were compatible with a congenital simple hamartoma of the retinal pigment epithelium. It is very important to detect this tumor and differentiate it from other pigmented fundus lesions that can compromise visual function or result in systemic conditions such as those caused by malignant tumors.

Congenital simple hamartoma of the retinal pigment epithelium: a case report / Hamartoma congênito simples do epitéilo pigmentado da retina: relato de caso

We report the case of a 56-year-old woman who presented for a routine ophthalmological examination without visual symptoms and had a unilateral black retinal lesion that was detected by clinical examination. Fluorescein angiography and optical coherence tomography findings were compatible with a congenital simple hamartoma of the retinal pigment epithelium. It is very important to detect this tumor and differentiate it from other pigmented fundus lesions that can compromise visual function or result in systemic conditions such as those caused by malignant tumors.

Relato de um caso de paciente feminina de 56 anos que compareceu a uma consulta oftalmológica de rotina sem sintomas visuais e apresentando uma lesão retiniana preta, unilateral, detectada ao exame clínico. As características da angiografia fluoresceínica e da tomografia de coerência óptica foram compatíveis com hamartoma congênito simples do epitélio pigmentado da retina. É muito importante detectar este tumor e diferenciá-lo de outras lesões fundoscópicas pigmentadas que podem comprometer a função visual ou, além disso, afetar o paciente sistemicamente como em tumores malignos.

Anxiety symptoms in crack cocaine and inhalant users admitted to a psychiatric hospital in southern Brazil / Sintomas de ansiedade em usuários de crack e inalantes admitidos em uma unidade psiquiátrica na Região Sul do Brasil

OBJECTIVE: The occurrence of psychiatric comorbidity among individuals with crack or inhalant dependence is frequently observed. The objective of this study was to investigate anxiety symptoms among crack cocaine and inhalant users in southern Brazil. METHODS: The study investigated two groups of volunteers of equal size (n = 50): one group consisted of crack cocaine users, and the other group consisted of inhalant users. Research volunteers completed the Portuguese versions of the State-Trait Anxiety Inventory (STAI), Hamilton Anxiety Rating Scale (HAM-A), and Self-Report Questionnaire (SRQ). RESULTS: Both crack and inhalant users experience significant symptoms of anxiety. Inhalant users presented significantly more anxiety symptoms than crack users according to the HAM-A questionnaire only. In contrast to the results of the HAM-A, the STAI failed to demonstrate a significant difference between the two groups of substance users. SRQ scores revealed that crack and inhalants users had significant degrees of morbidity. CONCLUSION: A significant difference regarding anxiety symptomatology, especially state anxiety, was observed among inhalant and crack users. Anxiety and overall mental psychopathology were significantly correlated in this sample. The results indicate that screening initiatives to detect anxiety and additional psychiatric comorbidities among crack and inhalant users are feasible and relevant.

OBJETIVO: Investigar sintomas de ansiedade em usuários de crack e inalantes no Sul do Brasil. MÉTODOS: Oestudo investigou dois grupos de voluntárioscomomesmonúmero de indivíduos (n = 50): um grupo consistiu de usuários de crack e o outro grupo, de usuários de inalantes. Os voluntários da pesquisa completaram as versões em português das escalas de ansiedade State-Trais Anxiety Inventory (STAI) e Hamilton Anxiety Rating Scale (HAM-A), e o Questionário de Autoavaliação (SRQ). RESULTADOS: Ambos os grupos apresentaram sintomas significativos de ansiedade. Os usuários de inalantes apresentaram escores quanto a HAM-A significativamente superiores aos usuários de crack. Ansiedade e psicopatologia geral se apresentaram significativamente correlacionados. CONCLUSÃO: Sintomas de ansiedade são frequentes entre usuários de crack e inalantes. Um processo de triagem de sintomas de ansiedade entre usuários de crack e inalantes deve facilitar ainda mais as intervenções terapêuticas nesta área.

Anxiety symptoms in crack cocaine and inhalant users admitted to a psychiatric hospital in southern Brazil.

OBJECTIVE: The occurrence of psychiatric comorbidity among individuals with crack or inhalant dependence is frequently observed. The objective of this study was to investigate anxiety symptoms among crack cocaine and inhalant users in southern Brazil. METHODS: The study investigated two groups of volunteers of equal size (n=50): one group consisted of crack cocaine users, and the other group consisted of inhalant users. Research volunteers completed the Portuguese versions of the State-Trait Anxiety Inventory (STAI), Hamilton Anxiety Rating Scale (HAM-A), and Self-Report Questionnaire (SRQ). RESULTS: Both crack and inhalant users experience significant symptoms of anxiety. Inhalant users presented significantly more anxiety symptoms than crack users according to the HAM-A questionnaire only. In contrast to the results of the HAM-A, the STAI failed to demonstrate a significant difference between the two groups of substance users. SRQ scores revealed that crack and inhalants users had significant degrees of morbidity. CONCLUSION: A significant difference regarding anxiety symptomatology, especially state anxiety, was observed among inhalant and crack users. Anxiety and overall mental psychopathology were significantly correlated in this sample. The results indicate that screening initiatives to detect anxiety and additional psychiatric comorbidities among crack and inhalant users are feasible and relevant.

Depressive symptoms in crack and inhalant users in Southern Brazil.

In this study the authors investigated depressive symptoms and correlated psychopathology in crack cocaine and inhalant users in Southern Brazil. Participants completed the Beck Depression Inventory, the Montgomery-Asberg Depression Rating Scale, and the Hamilton Depression Rating Scale. General psychopathology, hopelessness and suicidal tendencies were also investigated. Crack and inhalants users presented significant levels of depressive symptoms and psychiatric morbidity. These disorders were significantly associated with hopelessness and suicidal tendencies. These findings underscore the need for more rigorous and extensive screening efforts to detect and treat depressive symptoms in crack and inhalent users.

Perfil demográfico dos pacientes atendidos na Campanha de Catarata da Santa Casa de Porto Alegre / Demographic profile of patients assisted on Cataract Campaign in Santa Casa de Porto Alegre

OBJETIVO: Avaliar o perfil demográfico dos pacientes atendidos na Campanha da Catarata e correlacionar as características do sistema de referenciamento com o desfecho cirúrgico. MÉTODOS: Estudo prospectivo, observacional, realizado com pacientes atendidos no ambulatório de Oftalmologia do Hospital Santa Clara do Complexo Hospitalar Santa Casa de Porto Alegre referenciados à consulta via Campanha de Catarata entre fevereiro e abril de 2008. Foi utilizado questionário de avaliação dos pacientes atendidos e realizado exame oftalmológico de biomicroscopia e fundoscopia. RESULTADOS: Dos 234 pacientes com questionários completos, a média de espera pela consulta no sistema terciário foi de 2,5 meses, variando de 1 a 24 meses. Do total de pacientes incluídos no estudo, 152 (65 por cento) foram operados. CONCLUSÃO: Através da análise do atendimento dos pacientes referenciados pôde-se perceber, pelo tempo de espera para a consulta no sistema terciário e pelo percentual de pacientes operados, a eficiência e agilidade proporcionada por esse tipo de campanha de saúde pública.

OBJECTIVE: Evaluate the demographic profile of patients assisted on Cataract Campaign and correlate the characteristics of the reference system incoming patients with surgery results. METHODS: Prospective study, observational, performed with outpatients assisted on the Ophthalmology Ambulatory of Santa Clara's Hospital (Complexo Hospitalar Santa Casa de Porto Alegre) in Cataract Campaign between february and april 2008. It was utilized a questionnaire to evaluate assisted patients and performed the ophthalmological exam by biomicroscopy and fundoscopy. RESULTS: From 234 patients with complete questionnaire, the average waiting time for the consult in the tertiary system was 2,5 months, varying from 1 to 24 months. From the total of patients included in the study, 152 (65 percent) were operated. CONCLUSION: Through the analyses of the attending patients who were referred we can realize by the time of waiting for the consult in the tertiary system and by the percentage of patients operated the efficiency and agility provided by this public health campaign.

The Portuguese version of the Breastfeeding Self-Efficacy Scale-Short Form.

The objective of this study was to translate and psychometrically assess a Portuguese version of the Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF). The original English version of the BSES-SF was translated to Portuguese and tested among a sample of 89 mothers in southern Brazil from the 2nd to 12th postpartum week followed by face-to-face interviews. The mean total score of the Portuguese version of the BSES-SF was 63.6 +/- 6.22. The reliability analysis of each item in the scale attained significant Cronbach's alphas of 0.63 or superior. The Cronbach's alpha generated by the entire range of 14 questions was 0.71. A factor analysis identified one factor that contributed to 20% of the variance. This study demonstrates that the original English version of the BSES-SF was successfully adapted to Portuguese. The Portuguese version of the BSES-SF constitutes a reliable research instrument for evaluating breastfeeding self-efficacy in Brazil.

The correlation between postpartum depression and health status.

To investigate a purported correlation between postpartum depression and self-rated maternal general health status in a sample of mothers in Southern Brazil. As part of this process, the Personal Health Scale (PHS), a self-rated health status measure, was tested for the first time among postpartum women. Research volunteers completed the Structured Clinical Interview for DSM-IV Disorders (SCID), the 12-item General Health Questionnaire (GHQ), the PHS, the Postpartum Depression Screening Scale (PDSS), and the Edinburgh Postnatal Depression Scale (EPDS). Correlation coefficients were computed among the scores of the health status questionnaires and the postnatal depression scales. Bivariate linear regression analyses were conducted to evaluate the prediction of scores of postnatal depression scales having the scores of health status questionnaires as predictors. Significant correlations among both health status questionnaires and both postnatal screening tools attest to a significant interconnection between the expression of depressive symptoms and maternal health status in the postpartum period. The health status measures predicted the scores of postpartum depression scales. This study demonstrates that both general health questionnaires and postpartum depressive rating scales are useful tools for detecting depressive phenomena in postpartum women. The association between self-rated health measures and postpartum depression may be even more significant in the context of socioeconomic deprivation.

Validation of a screening instrument for postpartum depression in Southern Brazil.

OBJECTIVES: The objectives of this investigation was to assess the prevalence of postpartum depression in a sample of 101 women and to validate a Portuguese version of the Postpartum Depression Screening Scale (PDSS) in Southern Brazil. METHODS: Research volunteers completed the PDSS and underwent an assessment based on the Structured Clinical Interview for DSM-IV disorders (SCID). Parameters under investigation included the demographic characteristics of the sample, internal structure, and discriminant validity. RESULTS: All questions in the Portuguese version of the PDSS attained significant Cronbach's alpha of 0.62. The factorial analysis of the Portuguese version of PDSS identified one principal factor that contributed 38.8% of the variance. The best cut-off score for the Portuguese version of the PDSS was a score of 81, which accounted for a sensitivity of 89% and a specificity of 72% in this sample. CONCLUSIONS: The Portuguese version of the PDSS demonstrated sound psychometric properties. The results of the factorial analysis also demonstrated that the Portuguese version of the PDSS assesses postpartum depressive disorders in a coherent and integrated manner. The original English version of the PDSS was successfully adapted to Portuguese.

Portuguese version of the Quality of Life Enjoyment and Satisfaction Questionnaire: a validation study.

OBJECTIVE: The aim of this study was to demonstrate the validity and reliability of the Portuguese version of the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q) among substance users in southern Brazil. METHODS: The original English version of the Q-LES-Q was translated into Portuguese taking into account semantic and conceptual equivalence. The Portuguese versions of the Q-LES-Q and the World Health Organization Quality of Life Instrument (WHOQOL-BREF) were used to assess quality of life among crack cocaine and inhalant users. Factorial and reliability analyses as well as correlation studies were conducted to establish the psychometric properties of the Portuguese version of the Q-LES-Q. RESULTS: All areas of the Q-LES-Q achieved significant Cronbach's coefficients. Significant Pearson correlation coefficients were obtained between various subscales of the Q-LES-Q and the four dimensions of the WHOQOL-BREF. Correlations were significant when crack and inhalant users were analyzed separately or conjointly. Inhalant users presented significantly higher scores than crack users in the social (p=0.035) and general (p=0.005) subscales of the Q-LES-Q. CONCLUSION: The Portuguese version of the Q-LES-Q possesses sound internal validity. The English version of the Q-LES-Q was adequately adapted to Portuguese. Inhalant users may present lower levels of satisfaction with social life and overall quality of life than crack users. The Portuguese version of the Q-LES-Q is a reliable questionnaire for future research and clinical use with substance users in Brazil.

Portuguese version of the Quality of Life Enjoyment and Satisfaction Questionnaire: a validation study / Estudio de validación de la versión en portugués del cuestionario sobre calidad de vida: satisfacción y placer

OBJECTIVE: The aim of this study was to demonstrate the validity and reliability of the Portuguese version of the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q) among substance users in southern Brazil. METHODS: The original English version of the Q-LES-Q was translated into Portuguese taking into account semantic and conceptual equivalence. The Portuguese versions of the Q-LES-Q and the World Health Organization Quality of Life Instrument (WHOQOL-BREF) were used to assess quality of life among crack cocaine and inhalant users. Factorial and reliability analyses as well as correlation studies were conducted to establish the psychometric properties of the Portuguese version of the Q-LES-Q. RESULTS: All areas of the Q-LES-Q achieved significant Cronbach's coefficients. Significant Pearson correlation coefficients were obtained between various subscales of the Q-LES-Q and the four dimensions of the WHOQOL-BREF. Correlations were significant when crack and inhalant users were analyzed separately or conjointly. Inhalant users presented significantly higher scores than crack users in the social (p = 0.035) and general (p = 0.005) subscales of the Q-LES-Q. CONCLUSION: The Portuguese version of the Q-LES-Q possesses sound internal validity. The English version of the Q-LES-Q was adequately adapted to Portuguese. Inhalant users may present lower levels of satisfaction with social life and overall quality of life than crack users. The Portuguese version of the Q-LES-Q is a reliable questionnaire for future research and clinical use with substance users in Brazil.

OBJETIVO: Demostrar la validez y consistencia de la versión en portugués del cuestionario sobre calidad de vida: satisfacción y placer (Q-LES-Q) en consumidores de drogas del sur de Brasil. MÉTODOS: Se tradujo la versión original en inglés del Q-LES-Q al portugués tomando en cuenta las equivalencias semántica y conceptual. Se utilizaron la versión en portugués del Q-LES-Q y la escala de calidad de vida de la Organización Mundial de la Salud (WHOQOL-BREF) para evaluar la calidad de vida de personas que consumían basuco (crack) e inhalantes. Se realizaron análisis factoriales y de consistencia y estudios de correlación para establecer las propiedades psicométricas de la versión en portugués del Q-LES-Q. RESULTADOS: Todas las áreas del Q-LES-Q alcanzaron valores significativos del coeficiente de Cronbach. Se obtuvieron coeficientes de correlación de Pearson significativos entre varias subescalas del Q-LES-Q y las cuatro dimensiones de la WHOQOL-BREF. La correlación fue significativa para los consumidores de basuco y de inhalantes por separado y en conjunto. Los consumidores de inhalantes presentaron puntuaciones significativamente mayores que los consumidores de basuco en las subescalas social (P = 0,035) y general (P = 0,005) del Q-LES-Q. CONCLUSIONES: La versión en portugués del Q-LES-Q posee una sólida validez interna. La versión en inglés del Q-LES-Q se adaptó adecuadamente al portugués. Los consumidores de inhalantes pueden presentar niveles más bajos de satisfacción con la vida social y la calidad general de vida que los consumidores de basuco. La versión en portugués del Q-LES-Q es un instrumento confiable tanto para investigaciones futuras como para uso clínico en consumidores de drogas en Brasil.

Topiramato versus Glaucoma Agudo de Ângulo Fechado / Topiramate versus Angle- Closure Glaucoma

Topiramato é um tipo de sulfa monossacarídica de uso oral usado primariamente como anticonvulsivante e não apresenta relação estrutural com outros agentes antiepilépticos. Esta medicação anti-epiléptica de amplo espectro também tem sido usada no manejo de enxaqueca, depressão e dor neuropática. Desde a sua aprovação como anticonvulsivante, diversos relatos tem sido publicados relacionando-o a efeitos oftalmológicos adversos. Os achados patológicos incluem glaucoma secundário a fechamento de ângulo, miopia transitória, hiperemia ocular, efusões uveais, podendo ou não estar presente midríase.

Topiramate is a kind of sulfamate-substituted monosaccharide of oral presentation to be used primarily as an anticonvulsant and it doesn't have structural relation with any other antiepileptic agents. This wide range antiepileptic drug has been used in the management of migraine, depression and neuropathic pain. Since it was approved as an anticonvulsant, many reports related to ophthalmological adverse effects have been published. The pathological findings include secondary angle closure glaucoma, transitory myopia, ocular hyperemia, uveal effusions, with or without mydriasis.