12 research outputs found

    Descemet membrane endothelial keratoplasty in a patient with iris-fixated intraocular lens and prior radial keratotomy: a case report

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    Abstract Background Anterior segment surgeries such as cataract surgery, intraocular lens (IOL) repositioning, and radial keratotomy (RK) may hasten endothelial dysfunction, particularly in the context of pre-existing Fuchs dystrophy, necessitating future corneal transplantation. Case presentation A 68-year-old woman with a history of RK with associated irregular astigmatism in both eyes and iris-fixated intraocular lens (IF-IOL) in the left eye presented with six months of decreased vision in the left eye. She was found to have Fuchs dystrophy and underwent DMEK surgery. She had an uncomplicated postoperative course, with uncorrected visual acuity improving to 20/20 three months after surgery. Conclusion To our knowledge, this is the first reported case of a highly successful DMEK surgery in a patient with prior RK and IF-IOL

    Drawing the Line: How African, Caribbean and White British Women Live Out Psychologically Abusive Experiences

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    The final, definitive version of this paper has been published in Violence Against Women, 19 (9):1104-32, Sept 2013 by SAGE Publications Ltd, All rights reserved. © The Author(s) 2013. The online version of this article can be found at: http://vaw.sagepub.com/content/19/9/110

    Violência contra gestantes: prevalência e fatores associados nas maternidades públicas de uma região metropolitana do sul do país

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    Tese (doutorado) - Universidade Federal de Santa Catarina, Centro de Ciências da Saúde, Programa de Pós-Graduação em Saúde Coletiva, Florianópolis, 2014.O estudo em discussão refere-se à violência doméstica contra as gestantes que é aquela que ocorre em uma relação íntima.É dividida, quanto à natureza, em psicológica, física e sexual. Os objetivos são estimar a prevalência e fatores associados à violência doméstica em mulheres no período gestacional, identificar quais os tipos de violência (física, sexual, psicológica) a mulher sofre durante a gestação, avaliar o padrão de violência antes e durante a gestação e caracterizar o autor das agressões. A população de referência caracterizou-se por 753 mulheres puérperas, cujos filhos nasceram no período compreendido entre 01/03/2014 a 31/05/2014 e que estavam internadas nos setores de alojamento conjunto das Maternidades Públicas dos Hospitais da Grande Florianópolis, Santa Catarina. Realizou-se estudo transversal, por meio de entrevistas, face a face. Foi adotado questionário adaptado da organização Mundial da Saúde (OMS) denominado Estudo Multi- Países sobre Saúde da Mulher e Violência Doméstica(WHOVAW), validado no Brasil. As variáveis utilizadas foram: de interesse central(violência doméstica durante a gestação),demográficas(idade, cor da pele),socioeconômicas(escolaridade, trabalho atual, renda), relacionas à gestação(gravidez planejada, número de consultas, abortos), de comportamentos relacionado à saúde(uso de álcool, fumo, drogas),relacionados às situações de violência(brigas do casal, envolvimento em brigas com terceiros, violência em gestações anteriores, violência no último ano). A variável de interesse central foi correlacionada com as demográficas, socioeconômicas, de comportamentos relacionados à saúde, e,também, às situações de violência. Foram realizadas análises multivariadas. A prevalência de sofrer violência durante a gestação foi de 17,8%. A violência psicológica (17,5%), mostrou-se mais elevada do que a física (5,4%) e a sexual(0,1%). No que diz respeito ao padrão da violência, observa-se aumento da violência na gestação atual (17,8%), quando comparada ao ano precedente (3,1%). Observou-se que as variáveis que permaneceram mais fortemente associadas ao desfecho foram mulheres que já haviam sofrido violência nos últimos doze meses, que haviam sido agredidas em gestações anteriores, que faziam consumo de álcool, não brancas, que apresentavam transtorno mental comum e que não trabalhavam. Na caracterização do autor das agressões contra a mulher durante a gestação, a associação maior foi o consumo de álcool, uso de drogas, envolvimento em brigas, ter realizado agressões em gestações anteriores e ter agredido sua parceira na última gestação.Abstract : This study refers to domestic violence against pregnant women. This violence occurs in an intimate relationship and is divided to psychological, physical and sexual. The objectives are to estimate the prevalence and factors associated with domestic violence in women during pregnancy, identify what types of violence (physical, sexual, psychological) women suffer during pregnancy, to evaluate the pattern of violence before and during pregnancy and to characterize perpetrators. The study population was 753 puerperal women whose children were born in the period from 03.01.2014 to 05.31.2014 and who were hospitalized in the rooming sectors of Public Maternity Hospitals in Florianópolis, Santa Catarina. Using interviews, face to face across-sectional study was done with an adapted questionnaire from the World Health Organization (WHO), validated in Brazil named Multi-Country Study on Women's Health and Domestic Violence (WHOVAW). The interest central variable studied were: (domestic violence during pregnancy), demographic (age, skin color), socioeconomic (education, current employment, income), related to pregnancy (unplanned pregnancy, number of doctor visits, abortions), of health-related behaviors (alcohol use, smoking, drugs use), related to violence situation (couple fights, involvement in fights with others, violence in previous pregnancies, violence in the last year). The central interest variable was correlated with demographic, socioeconomic, health-related behaviors, and also to violence situation. Multivariate analyzis were performed. The prevalence of suffering violence during pregnancy was 17.8%. Psychological violence (17.5%), proved to be higher than the physical (5.4%) and sexual (0.1%). With regard to the pattern of violence, there is increasing violence in the current pregnancy (17.8%) compared to the previous year (3.7%). It was observed that the variables that remained more strongly associated without come were women who had experienced violence in the last twelve months, which had been battered in previous pregnancies, who were alcohol consumption, color skin not white, who had common mental disorders and did not had a job. In characterizing the author of assaults against women during pregnancy, the largest association was alcohol consumption, drug use, involvement in physical fights, done assaults in partner previous pregnancies and assaulting his partner in the last pregnancy

    Current issues around the pharmacotherapy of ADHD in children and adults

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    Background New drugs and new formulations enter the growing market for ADHD medication. The growing awareness of possible persistence of ADHD impairment beyond childhood and adolescence resulting in increased pharmacotherapy of ADHD in adults, is also a good reason for making an inventory of the what is generally known about pharmacotherapy in ADHD. Aim To discuss current issues in the possible pharmacotherapy treatment of ADHD in children, adolescents and adults with respect to the position of pharmacotherapy in ADHD treatment guidelines, the pharmacoepidemiological trends, and current concerns about the drugs used. Methods A search of the literature with an emphasis on the position of pharmacotherapy in ADHD treatment guidelines, the pharmacoepidemiological trends, and current concerns about the drugs used in pharmacotherapy. Results According to the guidelines, the treatment of ADHD in children consists of psychosocial interventions in combination with pharmacotherapy when needed. Stimulants are the first-choice drugs in the pharmacological treatment of ADHD in children despite a number of well known and frequently reported side effects like sleep disorders and loss of appetite. With regard to the treatment of adults, stimulant treatment was recommended as the first-choice pharmacotherapy in the single guideline available. Both in children and adults, there appears to be an additional though limited role for the nonadrenergic drug atomoxetine. The increase of ADHD medication use, in children, adolescents and in adults, can not only be interpreted as a sign of overdiagnosis of ADHD. Despite the frequent use of stimulants, there is still a lack of clarity on the effects of long-term use on growth and nutritional status of children. Cardiovascular effects of both stimulants and atomoxetine are rare but can be severe. The literature suggests that atomoxetine may be associated with suicidal ideation in children. Conclusion Although pharmacotherapy is increasing common in the treatment of ADHD in both children and adults, there are still a lot of questions about side effects and how best to counter them. This suggests an important role for close monitoring of children and adults treated with stimulants or atomoxetin
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