SIGNIFICAÇÕES ATRIBUÍDAS POR PORTADORES DE VISÃO MONOCULAR À PERDA VISUAL E CIRURGIA DE CATARATA

Purpose: To identify perceptions and significations relating to the visual loss and the cataract surgery among monocular vision patients who present surgical indication by means of a impairment. Methods: A qualitative study through open interviews with 8 individuals identified by the Cataract Project, was conducted in Hospital das Clínicas, São Paulo University Medical School (HC-FMUSP), during November, 2004. Results: The study included 4 women and 4 men, ages from 38 to 86 years old. They reported professional activities as liable for the visual loss, pointed out difficulties to get medical care and revealed popular beliefs and insufficient knowledge about their own ocular problem. Conclusions: Meanings, perceptions, feelings, reactions and experiences were identified related to cataract and visual loss, in general attributed to their professional activity. The occurence of cataract in a single eye signified to them anguish and conflictive situation related to loss of independence. Expectancy of seeing again through surgical procedure became attached to the sense of having a normal and useful life and by the fact of returning to the labour market. Objetivo: Identificar percepções e significados referentes à perda visual de pacientes que apresentavam visão monocular e diagnóstico de catarata, com indicação cirúrgica, por comprometimento visual significativo. Métodos: Desenvolveu-se estudo qualitativo, por meio de entrevistas abertas, com 8 sujeitos identificados por Campanha da Catarata, realizada no Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP), em novembro de 2004.Resultados: Dos entrevistados, 4 eram do sexo feminino e 4 do sexo masculino, tendo a idade variado de 38 a 86 anos. Referiram atividades profissionais como responsáveis pela perda visual, apontaram dificuldades para conseguir o atendimento médico, manifestaram desconhecimento e crenças populares em relação ao próprio problema ocular e dificuldades encontradas no cotidiano em decorrência da doença. Conclusões: Foram identificados significados, percepções, sentimentos, reações e experiências relacionados à catarata e à perda visual. A ocorrência da catarata no único olho significou angústia e situação conflituosa relacionadas à perda da independência. A expectativa de voltar a enxergar mediante intervenção cirúrgica prendeu-se ao sentimento de ter uma vida “normal”, de sentir-se útil e do retorno ao mercado de trabalho. 

ATIVIDADE OCUPACIONAL E CATARATA SENIL – OPINIÃO DE PACIENTES DE HOSPITAL UNIVERSITÁRIO

Purpose: To identify perceptions about relationship between the occupational activity and origin of the disease in persons with senile cataract. Methods: A descriptive observational transversal study was developed by a structured questionnaire which was applied during interviews elaborated from an exploratory study . The sample was accessible with patients with cataract in an ophthalmogical clinic of an university hospital. Results: One hundred and ten persons of boths genders (34,5% males and 65,5% females aged between 43 and 89 years old were submitted to the study. The great proportion of persons was not developing payed activities (87,3%). Among the most frequent opinions about the causes of cataract were advanced age (69,1%), excessive use of the vision (57,3%) and influence of hot temperatures against the eyes (40,9%). Regarding the opinions about the relation between professional activities and development of cataract, 56,4% did not believe that the activity shown had influence in the origin of disease, while 43,6% believed in a relation between the occupational activity and the development of the disease. Visual strain (37,5%), excessive hot temperatures (12,5%) and use of chemical substances (10,3%) were the attributable causes of cataract related to professional activities. Conclusions: We observed a great predominance of aged with low schooling and not developing payed activities persons and retired from the work market suggesting low socio-economic levels and low acquisitive power. Situations indicated by the examined persons as excessive use of the vision and hot temperatures suffered by the eyes during occupational activities suggest an erroneous knowledge about disease. Objetivo: Identificar a situação ocupacional e percepções de portadores de catarata senil sobre a relação entre a atividade ocupacional exercida e o surgimento da doença. Métodos: Desenvolveu-se estudo observacional transversal descritivo, por meio de questionário estruturado, aplicado por entrevista, elaborado a partir de estudo exploratório. A amostra, prontamente acessível, foi formada por pacientes atendidos pelo setor de catarata da clínica oftalmológica de um hospital universitário. Resultados: A amostra foi constituída por 110 sujeitos de ambos os sexos (34,5% homens; 65,5% mulheres), com idade entre 43 e 89 anos, ± 10,3 anos. A maior proporção dos entrevistados não exercia atividade remunerada (87,3%). Dentre as opiniões acerca das causas da catarata, destacaram-se a velhice (69,1%), o uso excessivo dos olhos (57,3%) e a exposição ao calor nos olhos (40,9%). Quanto à opinião sobre relação entre atividades profissionais exercidas e catarata, 56,4% não acreditavam que o trabalho tivesse influído, enquanto 43,6% atribuíram às atividades ocupacionais a essa afecção ocular. Foram atribuídos às atividades profissionais: o cansaço visual (37,5%), contato com calor excessivo (12,5%) e uso de produto químico (10,3%). Conclusões: Evidenciou-se predominância acentuada de idosos de baixa escolaridade, não mais exercendo atividade ocupacional e inativos no mercado de trabalho. Entre os que exerciam, prevaleceram as ocupações manuais especializadas, o que sugere reduzido nível socioeconômico e baixo poder aquisitivo. Atribuíram como causas do comprometimento visual situações decorrentes de atividades ocupacionais, como o uso excessivo dos olhos e a exposição ao calor, evidenciando-se conhecimentos errôneos.

Antiangiogenic Activity of 2-Deoxy-D-Glucose

During tumor angiogenesis, endothelial cells (ECs) are engaged in a number of energy consuming biological processes, such as proliferation, migration, and capillary formation. Since glucose uptake and metabolism are increased to meet this energy need, the effects of the glycolytic inhibitor 2-deoxy-D-glucose (2-DG) on in vitro and in vivo angiogenesis were investigated.In cell culture, 2-DG inhibited EC growth, induced cytotoxicity, blocked migration, and inhibited actively forming but not established endothelial capillaries. Surprisingly, 2-DG was a better inhibitor of these EC properties than two more efficacious glycolytic inhibitors, 2-fluorodeoxy-D-glucose and oxamate. As an alternative to a glycolytic inhibitory mechanism, we considered 2-DG's ability to interfere with endothelial N-linked glycosylation. 2-DG's effects were reversed by mannose, an N-linked glycosylation precursor, and at relevant concentrations 2-DG also inhibited synthesis of the lipid linked oligosaccharide (LLO) N-glycosylation donor in a mannose-reversible manner. Inhibition of LLO synthesis activated the unfolded protein response (UPR), which resulted in induction of GADD153/CHOP and EC apoptosis (TUNEL assay). Thus, 2-DG's effects on ECs appeared primarily due to inhibition of LLOs synthesis, not glycolysis. 2-DG was then evaluated in two mouse models, inhibiting angiogenesis in both the matrigel plug assay and the LH(BETA)T(AG) transgenic retinoblastoma model.In conclusion, 2-DG inhibits endothelial cell angiogenesis in vitro and in vivo, at concentrations below those affecting tumor cells directly, most likely by interfering with N-linked glycosylation rather than glycolysis. Our data underscore the importance of glucose metabolism on neovascularization, and demonstrate a novel approach for anti-angiogenic strategies

Perceptions Of Ophthalmologists Regarding Teaching Models Applied To Contact Lenses [percep_̧tioes De Oftalmologistas Referentes Ao Modelo De Ensino Aplicado A Lentes De Contato]

Purpose: To identify perceptions regarding teaching models applied to contact lenses. Methods: A transversal study in a readily accessible sample consisting of ophthalmologists (n=39) was performed by applying a questionnaire. Results: The sample consisted of 39 ophthalmologists, 51.3% males and 48.7% females. Regarding frequency prior to courses on contact lenses, 28.2% reported only one course; 25.6% two courses; 5.1% three courses; 2.6% five courses and 2.6% more than 10 courses. 23.1% never attended contact lens courses and 12.8% did not answer the questionnaire. On comparison of previous knowledge with that acquired by the offered course, 59.0% declared that they increased their knowledge a lot; 33.3% reported median increase; 2.6% little increase and 5.1% did not answer. As concerns training in contact lenses, 66.7% answered that they never had any training; 30.7% answered affirmatively and 2.6% did not answer. Among those who had training, 75% declared it was good; 16.7%, very good and 8.3%, regular. Conclusion: The offered teaching model for contact lenses was considered very valuable, increasing a great deal of knowledge in most subjects.694615619Ghanem-Coral, C., Kara-José, N., (2003) Lentes De Contato: Manual, , São Paulo: Conselho Brasileiro de OftalmologiaOliveira, P.R., Kara-José, N., Alves, M.R., Temporini, E.R., Observância da orientação médica pelo usuário de lentes de contato (2004) Arq Bras Oftalmol, 67 (4), pp. 607-612Brightbill, F.S., Laux, D.J., Contact lens fitting (1986), St Louis, MosbyBuxton, J.N., Contact lenses in keratoconus (1978) Contact Intraocular Lens Med J, 4, pp. 74-85Mannis, M.J., Therapeutic contact lenses (1994) The Cornea, pp. 723-737. , In: Smolin G, Thoft RA. Boston: Little BrownOliveira, P.R., Lentes terapêuticas (1998) Lentes De Contato Na Clínica Oftalmológica, pp. 107-112. , In: Ghanem-Coral C, Kara-José N. 2a ed. Rio de Janeiro: Cultura MédicaOliveira, P.R., Uso de lentes de contato: Percepções e conduta de funcionários de hospital e estudantes universitários da área de saúde (2001), [tese]. São Paulo: Faculdade de Medicina, Universidade de São PauloRegula e fiscaliza o exercício da medicina, da odontologia, da medicina veterinária e das profissões de farmacêutico. Artigo 39. É vedado à casas de ótica confeccionar e vender lentes de grau sem prescrição médica, bem como instalar consultórios médicos nas dependências dos seus estabelecimentos (1932), http://www.cbo.com.br/medicos/legislacao/dec_20931.htm, Rio de Janeiro. Governo Provisório da República dos Estados Unidos do Brasil. Decreto 20.931 de 11/01/ [texto na Internet]. [citado 2005 Nov 19]. Disponível emKara-José, N., Receita de lente de contato (2000) Sinopse Oftalmol, 4, p. 98. , [editorial]Conselho Regional de Medicina de São Paulo confirma oficialmente que adaptação de lentes de contato é um ato médico (1997) J Oftalmol Jota Zero, p. 8. , 1997 março/ abrilEstatuto da SOBLEC em vigor (2005), http://www.soblec.com.br/estatuto/atual0304.doc, Sociedade Brasileira de Lentes de Contato, Córnea e Refratometria - SOBLEC. [texto na Internet]. São Paulo: SOBLEC[citado 2005 Maio 28]. Disponível emCoral-Ghanemt, C., Kara-José, N., (1998) Lentes De Contato Na Clínica Oftalmológica, , 2a ed. Rio de Janeiro: Cultura Médic

Remembering trauma: Fugard's The Train Driver

Among Fugard's post-apartheid plays one escapes the sentimental nostalgia of his recent turn inwards - The Train Driver (2010). In it he develops a challenging sense of the country's dealings with the past by focusing on the remembering of a 'track suicide' by the white driver, whose tragic story is told by a black gravedigger. The driver's morbidly excessive reaction, the result of identifying with the victim whose grave he seeks, is balanced in performance by the sympathy and acceptance of the gravedigger. The squatter camp cemetery setting provides a liminal urban space stressing the continuity of past wrongs while the selective remembering of the nation's elite masks everyday poverty and violence

Fordyce nodules in a buccal membrane graft to the ocular surface

Purpose: To present a case of epibulbar Fordyce nodules, with a referral diagnosis of primary tumor.Methods: Case report.Results: A 38-year-old woman was referred for ocular oncology consultation because of a conjunctival lesion in the right eye. She had had a buccal mucous graft to treat recurrent pterygium 18 years earlier. the lesion consisted of multiple small, yellow granules over a pink, thickened mucosa from the 12 to 3 o'clock meridians. Excisional biopsy revealed multiple subepithelial sebaceous glands consistent with Fordyce nodules.Conclusions: Fordyce nodules are a possible late benign complication of buccal mucous grafts.Universidade Federal de São Paulo, Paulista Sch Med, Dept Ophthalmol, BR-04024002 São Paulo, BrazilUniversidade Federal de São Paulo, Paulista Sch Med, Dept Ophthalmol, BR-04024002 São Paulo, BrazilWeb of Scienc