Compliance to the treatment in a peripheric distric of Porto Alegre

Adesão ao tratamento é um elo do processo terapêutico do qual depende o sucesso de qualquer prescrição. Dificuldades interpostas ao objetivo de adesão se acentuam junto a populações mais carentes. Neste estudo, avaliou-se o nível de adesão apresentado por 71 pacientes atendidos ambulatorialmente, no período de agosto a novembro de 1986, numa Unidade Sanitária da Secretaria de Saúde e do Meio Ambiente localizada em uma vila popular de Porto Alegre. Só participaram da amostra os pacientes aos quais foram prescritos fármacos. Combinou-se o método de entrevista ao de "contagem de pílulas" em visitas domiciliares de surpresa, metodologia que visou adequarse às peculiaridades do local de realização da pesquisa. O nível de adesão ao tratamento encontrado foi de 53,5%. Não foram encontradas associações estatisticamente significativas entre adesão e várias variáveis pesquisadas. Fatores capazes de influenciar adesão, metodologia empregada e resultados são amplamente discutidos. Conclui-se que o problema de não-adesão a tratamentos prescritos no meio analisado é grave. Propõese que medidas estimuladoras de adesão sejam especificamente desenvolvidas e testadas junto a estas populações.Compliance is a very important link in the therapeutic process. The sucess of any treatment depends on it. This is even a more preocupating problem when medicai assistance is given to deprived communities. The authors measured the levei of compliance of 71 patients attending a government sponsored medicai ambulatory located in a peripheric district of the city of Porto Alegre. Only patients who had drugs prescribed from August/86 to November/86 were included. The methodology employed was conceived to meet special local requirements and combined the method of interview to pill counts conducted at surprise home visits. An overall compliance rate of 53,5% was found. Variables affecting compliance, methodological aspects and results are discussed. lt is concluded that the problem of non-compliance in the situation described is very serious. lt is suggested that compliance improving measures specially developed to these communities be tested in the future as a way to minimize the problem

Impact of HLA-B51 on Uveitis and Retinal Vasculitis: Data from the AIDA International Network Registries on Ocular Inflammatory Disorders

PurposeThe clinical relevance of human leukocyte antigen (HLA) subtypes such as HLA-B51 on Beh & ccedil;et's disease (BD)-related uveitis and non-infectious uveitis (NIU) unrelated to BD remains largely unknown.MethodsData were prospectively collected from the International AIDA Network Registry for BD and for NIU. We assessed differences between groups (NIU unrelated to BD and positive for HLA-B51, BD-related uveitis positive for HLA-B51 and BD-related uveitis negative for HLA-B51) in terms of long-term ocular complications, visual acuity (VA) measured by best corrected visual acuity (BCVA), anatomical pattern, occurrence of retinal vasculitis (RV) and macular edema over time.ResultsRecords of 213 patients (341 eyes) were analyzed. No differences in complications were observed (p = 0.465). With regard to VA, a significant difference was detected in median BCVA (p = 0.046), which was not maintained after Bonferroni correction (p = 0.060). RV was significantly more prevalent in NIU-affected patients who tested positive for HLA-B51, irrespective of the systemic diagnosis of BD (p = 0.025). No differences emerged in the occurrence of macular edema (p = 0.99).ConclusionsPatients with NIU testing positive for HLA-B51 exhibit an increased likelihood of RV throughout disease course, irrespective of a systemic diagnosis of BD. The rate of complications as well as VA are comparable between NIU cases unrelated to BD testing positive for HLA-B51 and uveitis associated with BD. Therefore, it is advisable to perform the HLA-B typing in patients with NIU or retinal vasculitis, even in the absence of typical BD features