RESUMO
OBJECTIVE: To evaluate the predictive clinical factors for ocular dryness and for the nursing diagnosis Risk for dry eye in the ocular surface of hospitalized adult patients in an intensive care unit. METHOD: A cross-sectional study was conducted between January and July 2016, with 206 patients (412 eyes). An inference about the presence of the diagnosis in the evaluated patients was performed by diagnostic nurses. The descriptive and inferential statistics subsidized the data analysis. RESULTS: 47.6% of the patients presented Risk for dry eye, and 52.4% were already diagnosed with ocular dryness. Statistical differences between the ocular dryness diagnosis in the right eye with hyperemia, mucous secretion, eyelid edema and lagophthalmia were identified. In addition, statistical differences were observed between hyperemia and eyelid edema with Risk for dry eye in the left eye and with the nursing diagnosis Risk for dry eye. CONCLUSION: Hyperemia, mucous secretion, eyelid edema and lagophthalmia are the predictive clinical factors for the nursing diagnosis Risk for dry eye and also of ocular dryness in the intensive care unit environment which deserve special attention in the preventive evaluation.
Assuntos
Síndromes do Olho Seco/epidemiologia , Unidades de Terapia Intensiva , Diagnóstico de Enfermagem , Adulto , Idoso , Estudos Transversais , Síndromes do Olho Seco/diagnóstico , Edema/epidemiologia , Doenças Palpebrais/epidemiologia , Feminino , Humanos , Hiperemia/epidemiologia , Masculino , Pessoa de Meia-Idade , Fatores de RiscoRESUMO
Studies aiming to associate the sodium/potassium (Na/K) ratio with hypertension use 24-hour urinary excretion as a daily marker of ingestion. The objective of this study was to evaluate the association between urinary Na/K ratio and structural and functional vascular alterations in non-diabetic hypertensive patients. In hypertensive patients (n = 72), aged between 40 and 70 years, both sexes (61% women), in use of hydrochlorothiazide, we measured blood pressure, 24-hour urine sample collection, assessment of carotid-femoral pulse wave velocity (cf-PWV, Complior), central hemodynamic parameters (SphygmoCor), and post-occlusive reactive hyperemia (PORH). The participants were divided according to the tertile of 24-hour urinary Na/K ratio. Each group contained 24 patients. Systolic blood pressure was higher in T2 (133 ± 9 vs 140 ± 9 mmHg, P = .029). C-reactive protein (CRP) presented higher values in T3 as compared to T1 [0.20(0.10-0.34) vs 1.19 (0.96-1.42) mg/dL, P < .001]. Higher values in T3 were also observed for aortic systolic pressure (aoSP) [119(114-130) vs 135(125-147) mmHg, P = .002] and cf-PWV (9.2 ± 1.6 vs 11.1 ± 1.5 m/s, P < .001). The urinary Na/K ratio presented significant correlations with proteinuria (r = .27, P = .023), CRP (r = .77, P < .001), cf-PWV (r = .41, P < .001), and post-occlusive reactive hyperemia on cutaneous vascular conductance (PORH CVC) (r = -.23, P = .047). By multivariate linear regression, it was detected an independent and significant association of cf-PWV with urinary Na/K ratio (R2 = 0.17, P < .001) and PORH CVC with CRP (R2 = 0.30, P = .010). Our data indicated that increased urinary Na/K ratio in non-diabetic hypertensive patients was associated with higher degree of inflammation, raised peripheral and central pressure levels, and changes suggestive of endothelial dysfunction and arterial stiffness.
Assuntos
Hipertensão/metabolismo , Hipertensão/fisiopatologia , Potássio/urina , Sódio/urina , Adulto , Idoso , Pressão Sanguínea/fisiologia , Determinação da Pressão Arterial/métodos , Proteína C-Reativa/análise , Velocidade da Onda de Pulso Carótido-Femoral/métodos , Estudos Transversais , Feminino , Hemodinâmica/efeitos dos fármacos , Humanos , Hidroclorotiazida/uso terapêutico , Hiperemia/epidemiologia , Hipertensão/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Proteinúria/epidemiologia , Inibidores de Simportadores de Cloreto de Sódio/uso terapêutico , Coleta de Urina/métodos , Rigidez Vascular/fisiologiaRESUMO
RESUMO Objetivo: Determinar os fatores epidemiológicos e analisar as principais causas etiológicas dos pacientes atendidos com queixa de olho vermelho no setor de urgência e emergência de um hospital oftalmológico de ensino do estado de Minas Gerais. Métodos: Foi realizado um estudo de prevalência observacional, analítico com amostra não probabilística formado pelos pacientes que compareceram no setor de urgência da Fundação Hilton Rocha nos meses de janeiro a abril de 2014 (n=1140). Foram analisadas as seguintes variáveis: gênero, idade, raça, profissão, escolaridade, renda, meio de transporte, tempo decorrido entre o sintoma inicial e o primeiro atendimento, dia da semana, presença de baixa da acuidade visual e diagnóstico. Resultados: A amostra apresentou 390 pacientes com queixa de olho vermelho, 57,4% (n=224) eram do sexo feminino, a idade variou entre 3 e 97 anos, sendo a média de 43,7 anos. A maioria dos pacientes (87,6%, n=341) procurou o serviço em até 14 dias do início dos sintomas e apenas 75 indivíduos (19,4%) apresentavam baixa acuidade visual. As classes econômicas inferiores (classes D e E) são predominantes entre os atendidos. A principal causa da queixa de olho vermelho foi conjuntivite e blefaroconjuntivite infecciosas (32,6%, n=127). Conclusão: A conjuntivite infecciosa foi a morbidade de maior incidência. A Fundação Hilton Rocha desempenha um papel importante no atendimento à urgência oftalmológica da rede pública de Minas Gerais, sendo importante identificar as principais causas de atendimento e ampliar os estudos epidemiológicos e sociais, a fim de melhorar o acesso da população às urgências oftalmológicas e nos dar subsídios para campanhas de orientação, voltadas principalmente para as classes sociais menos favorecidas.
ABSTRACT Objective: Determining the epidemiological factors and analyzing the main etiological causes of the patients treated with red-eye complaint at the urgency and emergency sector of the ophthalmological hospital in the state of Minas Gerais. Methods: A prevalence observational analytical study was performed with a non-probabilistic sample formed by patients who visited the emergency room of the Fundação Hilton Rocha Hospital from january to april 2014 (n=1140). The following variables investigated were: gender, age, race, profession, education, income, means of transportation, time elapsed between the first symptom and the first visit, day of the week, low visual acuity symptom, diagnosis and treatment. Results: Out of the sample of 390 patients with red eye complaint, 57.4 % (n= 224) were female and the age ranged from 3 to 97, with an average of 43.7 years of age. The majority of patients, 87.6% (n= 341) sought the service up to 14 days after the onset of symptoms, only 75 individuals (19.4 %) had low visual acuity. The lower economic classes (classes D and E) are prevalent among patients. The main cause of red eye complain was conjunctivitis and infectious blepharoconjunctivitis 32.6% (n= 127). Conclusion: Infectious conjunctivitis was the morbidity with the highest incidence. The Fundação Hilton Rocha plays an important role in providing urgent ophthalmological care in the public health network in Minas Gerais. It is important to identify the most frequent causes of medical service for ocular diseases and expand the epidemiological and social studies in order to improve people’s access to ophthalmic emergencies and give us subsidies for guidance campaigns, focused mainly on the lower social classes.
Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Túnica Conjuntiva/irrigação sanguínea , Conjuntivite/etiologia , Conjuntivite/epidemiologia , Hiperemia/etiologia , Hiperemia/epidemiologia , Estudos Transversais , Serviço Hospitalar de Emergência/estatística & dados numéricos , Oftalmopatias/etiologia , Oftalmopatias/epidemiologiaRESUMO
Immediately following surgical excision of a cerebral AVM, even normal brain tissue surrounding the lesion is subject to hemorrhage, a phenomenon termed normal perfusion pressure breakthrough (NPPB) syndrome or occlusive hyperemia. According to this theory, arteries supplying cerebral AVMs become dilated and lose their capacity to dilate or constrict to autoregulate pressure. Acutely after removal of a cerebral AVM, excessive blood pressure in these arterial feeders can cause normal brain tissue to bleed. However, this theory still remains controversial.
Assuntos
Humanos , Edema Encefálico , Hemorragia Cerebral , Hiperemia/cirurgia , Hiperemia/epidemiologia , Hiperemia/fisiopatologia , Hiperemia/prevenção & controle , Pressão Intracraniana , Malformações Arteriovenosas Intracranianas/complicaçõesRESUMO
OBJECTIVE: The aim of this study was to evaluate the change in hyperemia and intraocular pressure (IOP) in patients who switch from prostaglandin or prostamide to a fixed combination of prostamide and timolol maleate. DESIGN: A multicenter, longitudinal, noncontrolled, nonrandomized open trial was conducted. PARTICIPANTS: One hundred forty-four patients (282 eyes) were selected: 60 (41.6%) were on travaprost, 51 (35.4%) on bimatoprost, and 33 (22.9%) on latanoprost. All patients included were unable to attain adequate IOP control with monotherapy and had no contraindications to ß-blockers. INTERVENTION: Patients were treated with a fixed combination of bimatoprost and timolol maleate. Hyperemia was evaluated using a referential table, and IOP was measured at 8:00, 12:00, and 16:00 h both before and after 4 months of treatment. MAIN OUTCOME: IOP and hyperemia were compared at 2 time points: pretreatment and after 4 months. The mean of the 3 IOP measurements taken at various points during the day was considered for analysis. Generalized estimating equations were used for repeated measures and intereye dependency adjustments. RESULTS: Hyperemia and IOP were reduced in all 3 groups, with the same pattern for both eyes. The bimatoprost group had the highest levels of hyperemia before treatment when compared with the latanoprost as well as the travaprost group and had the greatest reduction in hyperemia after treatment (P < 0.01). Regarding IOP, all 3 groups had a significant reduction (P < 0.001), but the bimatoprost group had a lower pretreatment IOP when compared with the travaprost and latanoprost groups. CONCLUSION: A significant reduction in hyperemia was found after switching from monotherapy with prostaglandins or prostamide to a fixed combination of prostamide and a ß-blocker. IOP reduction was significant after the intervention in all 3 groups.
Assuntos
Amidas/efeitos adversos , Anti-Hipertensivos/efeitos adversos , Cloprostenol/análogos & derivados , Hiperemia/induzido quimicamente , Timolol/efeitos adversos , Amidas/administração & dosagem , Amidas/uso terapêutico , Anti-Hipertensivos/administração & dosagem , Anti-Hipertensivos/uso terapêutico , Bimatoprost , Cloprostenol/administração & dosagem , Cloprostenol/efeitos adversos , Cloprostenol/uso terapêutico , Combinação de Medicamentos , Seguimentos , Glaucoma/tratamento farmacológico , Humanos , Hiperemia/epidemiologia , Pressão Intraocular/efeitos dos fármacos , Latanoprosta , Estudos Longitudinais , Prostaglandinas F Sintéticas/administração & dosagem , Prostaglandinas F Sintéticas/efeitos adversos , Fatores de Tempo , Timolol/administração & dosagem , Timolol/uso terapêutico , TravoprostRESUMO
BACKGROUND AND PURPOSE: Transient global amnesia (TGA) is the inability to retain new information and to recall past events during a period of minutes or hours. Its etiology is unclear, and flow disturbances in the mesial temporal lobes secondary to venous congestion have been proposed as a potential cause. Ultrasonographic evaluation of the internal jugular vein (IJV) has demonstrated valvular insufficiency in TGA. The prevalence of valvular insufficiency in the IJV in patients with TGA was assessed. Subjects without TGA of similar sex, age, and vascular risk factor profiles served as controls. METHODS: A group of 142 patients with a clinical diagnosis of TGA within 7 days of the clinical event and 40 controls were prospectively evaluated. Venous Doppler examination of both IJVs was performed at baseline and after a manometer-controlled Valsalva maneuver. Valvular insufficiency was diagnosed when there was reflux for >0.8 seconds during the Valsalva maneuver. RESULTS: Valve insufficiency was found in at least one jugular vein in 113 of 142 patients with TGA (79.5%) and in 10 of 40 controls (25.0%), P<0.01. The right side was affected more often than the left side, P<0.01, and 26.8% of the patients had bilateral incompetence. CONCLUSIONS: Patients with TGA have a high prevalence of IJV valve insufficiency. This finding may have pathophysiologic implications. Doppler evaluation of the IJVs with dynamic maneuvers may help in the evaluation of this usually benign condition.
Assuntos
Amnésia Global Transitória/epidemiologia , Amnésia Global Transitória/etiologia , Hiperemia/complicações , Hiperemia/epidemiologia , Veias Jugulares/patologia , Válvulas Venosas/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Prospectivos , Insuficiência Venosa/complicações , Insuficiência Venosa/epidemiologia , Adulto JovemRESUMO
Foram encontrados 207 pacientes portadores de hanseníase, em hospital colônia, sendo 195 (94,2 por cento) da forma Virchowiana e 12 (5,8 por cento) tuberculóide. 147 (71 por cento) eram do sexo masculino e 60 (28,9 por cento) do sexo feminino. Setenta e sete (39,5 por cento) apresentaram alteraçöes dos anexos oculares e 89 (45,6 por cento) apresentaram alteraçöes do bulbo ocular, na forma Virchowiana. Madarose parcial de supercílio foi a alteraçäo dos anexos oculares mais frequentes (58 casos; 29,7 por cento) e a alteraçäo dos anexos oculares mais frequentes (58 casos; 29,7 por cento) e a alteraçäo do bulbo ocular mais frequente foi a diminuiçäo da sensibilidade corneana (72 casos); 36,9 por cento). Cegueira unilateral ocorreu em 30 (15,4 por cento) pacientes e bilateral em 13 (6,6 por cento) na forma Virchowiana