Unexplained ocular and visual symptoms: The need for a psychosomatic approach in Ophthalmology. / Síntomas visuales y oculares sin causa: La necesidad de un enfoque psicosomático en oftalmología.

INTRODUCTION: Psychogenic causes for some somatic symptoms have been widely recognised. In Ophthalmology however, there are few studies that address this issue, and current Ophthalmology Training Programs do not include formal teaching in Psychosomatics. Psychosomatic phenomena in ophthalmology are probably under-diagnosed, which may reduce therapeutic effectiveness, decrease patient and physician satisfaction, and increase health costs due to multiple consultations and prescriptions. The aims of this study were to describe patients with unexplained visual/ocular symptoms (UVOS), and to estimate the prevalence of psychological distress (PD) among them. MATERIALS AND METHODS: Consecutive adults with UVOS were recruited over a 12 month period. Complete medical history and ocular examination were performed to rule out organic disease. Psychological Distress was defined by the presence of one or more of the following criteria: psychiatric diagnosis, use of psychotropic medication, psychosomatic disease in other organs, and biographical crisis in the last 6 months. Results were compared with a control group. RESULTS: A total of 39 cases of UVOS were recruited, corresponding approximately to 3% prevalence. The large majority (74%) were female. The mean age was 41.8 years. The most common complaints were ocular surface irritation symptoms (51%) and unspecific visual disturbances (17%). At least 1 of the PD criteria was found in 100%, including 46.2% with psychiatric comorbidity, 48.7% with psychotropic medications, 64% with psychosomatic disease in other organs, and 48.7% with recent life-stressful events. PD indicators were statistically higher compared with control group (P<.05). CONCLUSIONES: There was a high frequency of PD indicators in patients with UVOS. Although the causative role of PD remains unclear, the presence of UVOS should warn the ophthalmologist of an underlying psychic conflict and to make an appropriate psychological intervention.

Perfil de tolerancia ocular de un cosmético para bebe in vivo / Ocular tolerance profile of a cosmetic product for babies in vivo

Introducción: el estudio realizado previo al mercadeo de un cosmético para satisfacer la necesidad de obtener el registro sanitario, contribuye a garantizar su seguridad y eficacia para prevenir un problema de salud pública. Objetivo: describir el riesgo ocular latente por un champú mediante pruebas in vivo. Métodos: se realizó un estudio clínico hermenéutico y reflexivo, bajo la observación directa macroscópica en términos de efectos clínicos; determinación de los efectos promedios en 6 conejos mediante la escala de valores según la OCDE y estudio histopatológico de una muestra de tejido del ojo. Resultados: el 50 % de los animales mostraron el nivel 1 de lesión ocular; el 16,67 % el nivel 2 y el 33,33 % el nivel 3. Ninguno de los animales mostró el nivel 4 (lesión máxima). El análisis del promedio de los efectos clínicos y el análisis histopatológico confirman la sensibilidad del conejo como referente experimental aplicable para los bebés. Conclusiones: el champú podría producir efectos oculares leves, pero el posible riesgo ocular debe ser advertido hasta que no se demuestre su inocuidad.

Introduction: the study that is performed for health registration before marketing any cosmetic product assures its safety and efficacy to prevent a public health problem. Objective: to describe the possible eye risk caused by a shampoo for babies through in vivo testing. Methods: a clinical exploratory and hermeneutic study based on direct macroscopic observation of clinical effects; determination of average effects in 6 rabbits by the OECD value scale and a histopathological study of a sample of eye tissue. Results: fifty percent of rabbits showed level 1 ocular injury; 16.67 % suffered level 2 whereas 33.33 % had level 3. None of the animals reached level 4 (maximum level in injuries). The analysis of the average clinical effects and the histopathological study confirmed the sensitivity of the rabbit as experimental reference that may be applicable to babies. Conclusions: the shampoo might cause mild eye effects; however the possible ocular risk must be stated until such time as the safety of the product is proven.

Toxicidad aguda oral y ensayos de irritación de extractos acuoso e hidroalcohólico de Momordica charantia L / Acute oral toxicity and irritation tests in aqueous hydroalcoholic extracts from Momordica charantia L

Fundamentación: los extractos de Momordica charantia L. poseen potencial terapéutico avalado científicamente que posibilita el empleo de esta planta en diversas enfermedades, sobre todo en la diabetes, por lo que caracterizar su potencial tóxico es de gran importancia para avalar el empleo de esta planta como agente terapéutico. Objetivos: realizar los estudios de toxicidad aguda oral e irritación ocular y dérmica a extractos acuoso e hidroalcohólico de M. charantia, con la finalidad de caracterizar su potencial toxicológico agudo. Métodos: el ensayo de toxicidad aguda oral se llevó a cabo en ratas Wistar hembras mediante el método de las clases tóxicas agudas, con la dosis máxima de 2 000 mg/kg. Los ensayos de irritación dérmica y ocular se llevaron a cabo en conejos Nueva Zelanda siguiendo los métodos descritos en las normas OECD 404 y 405. Resultados: la evaluación del extracto hidroalcohólico de M. charantia en el ensayo de toxicidad aguda mostró signos tóxicos por causa de la presencia de etanol en el extracto y una ligera disminución del peso corporal que no fue significativa. La administración del extracto acuoso no provocó signos tóxicos ni mortalidad. Ambos extractos se clasificaron en categoría 5 para ubicarse en el rango de toxicidad de una DL50> 2 000 mg/kg. En el ensayo de irritación dérmica y ocular se clasificaron los extractos como no irritantes. Conclusiones: los extractos evaluados mostraron un bajo potencial tóxico agudo tanto por vía oral como tópica.

Rationale: Momordica charantia L. extracts have scientifically-endorsed therapeutical potentialities that make the use of this plant possible in several diseases, mainly for diabetes, so characterizing its toxic potential is of great significance to support this plant as a therapeutical agent. Objectives: to conduct acute oral toxicity and ocular and dermal irritation studies on aqueous hydroalcoholic extracts from M. charantia, with the aim of characterizing its acute toxicological potential. Methods: Acute oral toxicity test was applied to female Wistar rats through acute toxic class method, with maximum dose of 2000 mg/kg. Ocular/dermal irritation tests were made in New Zealand rabbits, following the described methods in OECD standards 404 and 405. Results: the evaluation of M. charantia hydroalcoholic extract in the acute toxicity test showed toxic signs due to ethanol in the extract and a minimum bodyweight reduction that was not significant. The administration of water extract elicited neither toxic signs nor mortality. Both extracts were classified into category 5 within the range of toxicity of DL50> 2 000 mg/kg. The dermal/ocular irritation test indicated that the studied extracts were not irritating. Conclusions: The evaluated extracts showed low acute toxic potential for both oral and topical administration.

Toxicidad aguda oral y ensayos de irritación de extractos acuoso e hidroalcohólico de Momordica charantia L / Acute oral toxicity and irritation tests in aqueous hydroalcoholic extracts from Momordica charantia L

Fundamentación: los extractos de Momordica charantia L. poseen potencial terapéutico avalado científicamente que posibilita el empleo de esta planta en diversas enfermedades, sobre todo en la diabetes, por lo que caracterizar su potencial tóxico es de gran importancia para avalar el empleo de esta planta como agente terapéutico. Objetivos: realizar los estudios de toxicidad aguda oral e irritación ocular y dérmica a extractos acuoso e hidroalcohólico de M. charantia, con la finalidad de caracterizar su potencial toxicológico agudo. Métodos: el ensayo de toxicidad aguda oral se llevó a cabo en ratas Wistar hembras mediante el método de las clases tóxicas agudas, con la dosis máxima de 2 000 mg/kg. Los ensayos de irritación dérmica y ocular se llevaron a cabo en conejos Nueva Zelanda siguiendo los métodos descritos en las normas OECD 404 y 405. Resultados: la evaluación del extracto hidroalcohólico de M. charantia en el ensayo de toxicidad aguda mostró signos tóxicos por causa de la presencia de etanol en el extracto y una ligera disminución del peso corporal que no fue significativa. La administración del extracto acuoso no provocó signos tóxicos ni mortalidad. Ambos extractos se clasificaron en categoría 5 para ubicarse en el rango de toxicidad de una DL50> 2 000 mg/kg. En el ensayo de irritación dérmica y ocular se clasificaron los extractos como no irritantes. Conclusiones: los extractos evaluados mostraron un bajo potencial tóxico agudo tanto por vía oral como tópica(AU)

Rationale: Momordica charantia L. extracts have scientifically-endorsed therapeutical potentialities that make the use of this plant possible in several diseases, mainly for diabetes, so characterizing its toxic potential is of great significance to support this plant as a therapeutical agent. Objectives: to conduct acute oral toxicity and ocular and dermal irritation studies on aqueous hydroalcoholic extracts from M. charantia, with the aim of characterizing its acute toxicological potential. Methods: Acute oral toxicity test was applied to female Wistar rats through acute toxic class method, with maximum dose of 2000 mg/kg. Ocular/dermal irritation tests were made in New Zealand rabbits, following the described methods in OECD standards 404 and 405. Results: the evaluation of M. charantia hydroalcoholic extract in the acute toxicity test showed toxic signs due to ethanol in the extract and a minimum bodyweight reduction that was not significant. The administration of water extract elicited neither toxic signs nor mortality. Both extracts were classified into category 5 within the range of toxicity of DL50> 2 000 mg/kg. The dermal/ocular irritation test indicated that the studied extracts were not irritating. Conclusions: The evaluated extracts showed low acute toxic potential for both oral and topical administration(AU)