RESUMO
Alveolar hydatid disease, caused by the organism Echinococcus multilocularis, is a potentially lethal helminthic infection. After initial hepatic infestation, the organism may spread locally and hematogenously to distant sites. Death occurs secondary to hepatic failure, local extension into vital structures, or metastasis to the brain or lungs. A 67-year-old male Alaskan Eskimo developed decreased visual acuity secondary to a choroidal mass in the right eye eight years after an initial diagnosis of alveolar hydatid disease and four years before the development of symptomatic cerebral metastasis. A pathologic examination disclosed characteristic parasitic membranes involving the posterior pole of the right eye. To our knowledge, this is the first report of ocular involvement in alveolar hydatid disease.
Assuntos
Equinococose/patologia , Oftalmopatias/patologia , Idoso , Equinococose/diagnóstico , Equinococose/diagnóstico por imagem , Angiofluoresceinografia , Humanos , Masculino , Tomografia Computadorizada por Raios X , UltrassonografiaRESUMO
The efficacy of a small, portable, battery-operated, Q-switched neodymium-YAG laser with a slit-lamp delivery system was evaluated in a short-term pilot study. Iridotomies were created in 44 Eskimo eyes (23 patients) with occludable angles in Alaska's Kotzebue region. The laser was transported as regular baggage, was used in three villages (utilizing available facilities), and was operational within five minutes. Patent iridotomies were achieved in all eyes and with one pulse in 18 eyes (44%). Complications included transient bleeding from the iridotomy site in 23 eyes (52%), focal corneal opacities in 11 eyes (25%), and a transient immediate postoperative intraocular pressure elevation in nine eyes (20%). This appears to be the first portable laser system that can be used in frontier areas and underdeveloped nations to prophylactically treat pupillary-block glaucoma.
Assuntos
Glaucoma/cirurgia , Inuíte , Iris/cirurgia , Terapia a Laser , Idoso , Alaska , Ensaios Clínicos como Assunto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Saúde da População RuralRESUMO
Por meio de um levantamento bibliográfico sobre as políticas públicas no setor de medicamentos brasileiro, o artigo examina as principais características das ações aplicadas na área, ressaltando seus resultados e deficiências, bem como as dificuldades encontradas para consolidar uma política de medicamentos no Brasil. O estudo realizado se fundamentou na análise de artigos por meio das bases de dados Scielo e Lilacs e de outras fontes. Desde a extinta Central de Medicamentos (CEME) até a aprovação da Política Nacional de Medicamentos (PNM), todas as ações e projetos foram voltados principalmente para a reorientação da Assistência Farmacêutica na atenção básica, garantindo, por conseguinte, o acesso e o uso racional dos medicamentos essenciais.
Through a bibliography review of public policies in Brazilian medicine sector, this paper examines the main characteristics of actions implemented in this area, lighting their results and deficiencies, as well as the difficulties to consolidate a policy for medicines in Brazil. The study is based on analysis of articles searched in the Scielo and Lilacs databases and other sources. Since the extinct Medicine Center to the approval of the National Medicine Policy, all the actions and programs aimed mainly at the reorientation of Pharmaceutical Assistance in primary health are, to guarantee access and rational use of essential medicines essential.