Corneal Ulcer in a Sheep - Treatment with Third Eyelid Flap

Background: Corneal ulcers are frequently reported in the literature in several species, however, the treatment of traumatic lesions on the corneal surface of ruminants is still poorly described.  The use of the third eyelid flap is questioned when applied to deep ulcers, since the technique prevents the evolutionary follow-up of corneal healing and compromises care. However, several authors report its successful use for the treatment of superficial and deep corneal ulcers. This technique protects the ocular surface and prevents the occurrence of new lesions or their aggravation. The aim of this study was to report the treatment of corneal ulcers in sheep through the third eyelid flap associated with the use of topical antibiotics.Case: A 2-year-old Dorper sheep, with ocular discomfort, conjunctival hyperemia and mucopurulent secretion in the left eye, was assisted in a private rural property in the West region of Bahia, Brazil. The owner reported that before seeking veterinary help he used a spray based on oxytetracycline and hydrocortisone, which worsened the animal's condition. Upon inspection, it was observed eyelid asymmetry, slight lateralization of the head to the left, periorbital alopecia on the left face, intense blepharospasm in the left eye, with projection of the third eyelid occurring at times. The ophthalmic examination was performed after application of anesthetic eye drops based on proxymetacaine to reduce eye discomfort. A corneal stromal lesion, edema and fibrovascular tissue in the left eye were identified, but the cause of the lesion was not defined, with lagophthalmia, entropion, dystychiasis or ectopic cilia being ruled out. So, it was suggested that the lesion had occurred by a foreign body, such as dust or feed fiber.  The contralateral eye showed no changes, Schirmer 15 mm, no changes in sensory and sensory reflexes and negative fluorescein. No signal clinical disease. Due to the severity of the lesion, it was performed a third eyelid flap associated with drug treatment with ciprofloxacin eye drops, every 8 h for 21 days. The animal was placed in the right lateral decubitus position and palpebral akinesia was achieved with the application of 2 mL lidocaine without vasoconstrictor in the region of the auriculopalpebral nerve. This was followed by the routine performance of the third eyelid flap.Discussion: The delay in seeking veterinary care and the application of spray based on oxytetracycline and hydrocortisone aggravated the lesion, since the corticosteroid delays corneal healing and favors the aggravation of the lesion. After desensitization of the cornea, the animal allowed eye manipulation and it was possible to observe the lesion and choose the best treatment, with option for the third eyelid flap because it is a simple and fast technique, does not require special equipment or materials, ideal for performed in the field and is widely used in the treatment of injuries involving the cornea and, besides that, helps to contain corneal perforation and protect the ocular surface. Corneal debridement was also performed to remove necrotic debris and improve drug action, in addition to using broad-spectrum antibiotic eye drops until complete regeneration of the lesion. Twenty-one days after the surgical procedure, the patient had no ocular discomfort, the flap was removed and no changes in the corneal surface were observed. The treatment was considered satisfactory for the healing of the corneal ulcer, guaranteed the esthetics and visual function of the sheep.Keywords: keratitis, surgery, ciprofloxacin, ocular, ruminant

Bullous Keratopathy in a dog treated with Third Eyelid Flap and Autologous Serum Eye Drops

Background: Bullous Keratopathy (BK) is characterized by decompensation of the corneal stroma resulting in visual impairment by corneal opacity, discomfort, excessive tearing, blepharospasm and pain. The aim of this study was to report a case of BK in a dog and the complete recovery of the ocular structure and visual function, with a third eyelid flap associated with the use of autologous blood serum topically.Case: A 2-year-old Shih Tzu male dog, weighing 4.3 kg, with recurrent bilateral eye discomfort was brought to Ophthalmologist Veterinarian Assistance. The patient had already been seen by other veterinarians, but the signs returned in a short period of time after the prescription was suspended. During physical examination it was observed moderate blepharospasm in the right eye, epiphora in the left eye, and in both eyes was noted exophthalmos, medial corneal entropion, caruncle trichiasis and ectopic cilia in the upper and lower eyelids. Fluorescein test was positive in both eyes, and a large bullous, opaque and gelatinous lesion with irregular appearance was observed occupying a large part of the cornea of the right eye. Superficial corneal ulcer was diagnosed in left eye and BK in right eye, both probably in consequence of ectopic cilia presence. Surgical intervention was made, with the cauterization and excision of the ectopic cilia and third eyelid flap in the right eye. The cauterization of caruncle trichiasis was not authorized by the owner. Moxifloxacin eye drops in the dose of one drop four times a day in both eyes, lubricant based on hyaluronic acid in the dose of one drop four times a day in both eyes, and autogenous blood serum, obtained from the centrifugation of a blood sample of the dog itself, in the dose of one drop every hour in the right eye for 24 hours, and meloxicam in the dose of 0.1 mg/kg every 24 h for 3 days were prescribed. Elizabethan collar was recommended until removal of the third eye flap. During the surgery, a sample of eye secretion was collected and sent for culture and antibiogram and did not show growth of microorganisms. After seven days of the procedure, the animal did not show eye discomfort and corneal ulcer in the left eye was healed. The third eye flap remained stable until the return of 28 days and after removal of the capton, adhesions were identified, which were removed with Castroviejo scissors after application of topical anesthetic proxymetacaine hydrochloride eye drops. A fluorescein test was performed and the absence of corneal keratitis was confirmed. Discrete corneal scars (macula) were identified.Discussion: The patient in this report had several changes in ocular morphology that favored the formation of recurrent injuries which contributed to the formation of BK. The use of topical medications as unique treatment was not performed due to the severity of the lesion and the presence of alterations such as medial entropion, caruncle trichiasis and ectopic cilia that needed surgical corrections to resolve the causes of the lesions. In order to protect the cornea and provide compression of its epithelium, a third eyelid flap was performed, a low-invasive procedure that is quick and easy to perform. Ectopic cilia were cauterized to eliminate one of the causes of the corneal injuries, however, the other changes could not be corrected because they were not authorized by the owner. The adjuvant uses of ocular lubricant based on hyaluronic acid, a broad-spectrum topical antibiotic and mainly autogenous blood serum favored the epithelial reconstruction of the cornea by providing protection, vitamins, growth factors, immunoglobulins, anti-collagenolytic and bacteriostatic substances. The protocol used it enabled a rapid reduction in patient discomfort, reversal of injuries and recovery of visual function

Brazilian Research Consortium on Obsessive-Compulsive Spectrum Disorders guidelines for the treatment of adult obsessive-compulsive disorder. Part II: cognitive-behavioral therapy

Objectives: To summarize evidence-based cognitive-behavioral therapy (CBT) treatment and propose clinical interventions for adult patients with obsessive-compulsive disorder (OCD). Methods: The literature on CBT interventions for adult OCD, including BT and exposure and response prevention, was systematically reviewed to develop updated clinical guidelines for clinicians, providing comprehensive details about the necessary procedures for the CBT protocol. We searched the literature from 2013-2020 in five databases (PubMed, Cochrane, Embase, PsycINFO, and Lilacs) regarding study design, primary outcome measures, publication type, and language. Selected articles were assessed for quality with validated tools. Treatment recommendations were classified according to levels of evidence developed by the American College of Cardiology and the American Heart Association. Results: We examined 44 new studies used to update the 2013 American Psychiatric Association guidelines. High-quality evidence supports CBT with exposure and response prevention techniques as a first-line treatment for OCD. Protocols for Internet-delivered CBT have also proven efficacious for adults with OCD. Conclusion: High-quality scientific evidence supports the use of CBT with exposure and response prevention to treat adults with OCD

Family mother: speech prophylactic against the syphilis, Rio de Janeiro, 1878-1889

Made available in DSpace on 2012-09-06T01:12:09Z (GMT). No. of bitstreams: 2 license.txt: 1748 bytes, checksum: 8a4605be74aa9ea9d79846c1fba20a33 (MD5) 637.pdf: 662270 bytes, checksum: d33d4a6d998bccfef2308efbf15749e5 (MD5) Previous issue date: 2004Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sergio Arouca. Rio de Janeiro, RJ, Brasil.Através de documentos oficiais da Academia de Medicina do Rio de Janeiro e de jornais e periódicos que circulavam na cidade, a autora investigou os discursos profiláticos contra a sífilis. Esses discursos trazem consigo, além da busca de minimizar os estragos sociais da doença, inovações e reafirmações das estruturas tradicionais que envolviam o papel da mulher na sociedade. Estas não foram criadas pelos médicos da Academia, representaram um diálogo entre estes e as questões que estavam em pauta na sociedade. Esses médicos não inovaram ou reafirmaram padrões sozinhos, mas estavam inseridos nessa sociedade interagindo com ela no seu dia-a-dia. Esses discursos podem ser percebidos nos editores, na opinião pública, nos anúncios de periódicos, jornais e nas publicações dos profissionais da Academia de Medicina. No século XIX, em que especialmente a luta médica poderia ser aquela definida contra a alta mortalidade, vemos um recorte que marca o papel da mãe de família, tomada através do discurso profilático contra a sífilis, sobre o seu papel diante da continuidade e da saúde da famíli

Corneal Ulcer in a Sheep - Treatment with Third Eyelid Flap

Background: Corneal ulcers are frequently reported in the literature in several species, however, the treatment of traumatic lesions on the corneal surface of ruminants is still poorly described.  The use of the third eyelid flap is questioned when applied to deep ulcers, since the technique prevents the evolutionary follow-up of corneal healing and compromises care. However, several authors report its successful use for the treatment of superficial and deep corneal ulcers. This technique protects the ocular surface and prevents the occurrence of new lesions or their aggravation. The aim of this study was to report the treatment of corneal ulcers in sheep through the third eyelid flap associated with the use of topical antibiotics.Case: A 2-year-old Dorper sheep, with ocular discomfort, conjunctival hyperemia and mucopurulent secretion in the left eye, was assisted in a private rural property in the West region of Bahia, Brazil. The owner reported that before seeking veterinary help he used a spray based on oxytetracycline and hydrocortisone, which worsened the animal's condition. Upon inspection, it was observed eyelid asymmetry, slight lateralization of the head to the left, periorbital alopecia on the left face, intense blepharospasm in the left eye, with projection of the third eyelid occurring at times. The ophthalmic examination was performed after application of anesthetic eye drops based on proxymetacaine to reduce eye discomfort. A corneal stromal lesion, edema and fibrovascular tissue in the left eye were identified, but the cause of the lesion was not defined, with lagophthalmia, entropion, dystychiasis or ectopic cilia being ruled out. So, it was suggested that the lesion had occurred by a foreign body, such as dust or feed fiber.  The contralateral eye showed no changes, Schirmer 15 mm, no changes in sensory and sensory reflexes and negative fluorescein. No signal clinical disease. Due to the severity of the lesion, it was performed a third eyelid flap associated with drug treatment with ciprofloxacin eye drops, every 8 h for 21 days. The animal was placed in the right lateral decubitus position and palpebral akinesia was achieved with the application of 2 mL lidocaine without vasoconstrictor in the region of the auriculopalpebral nerve. This was followed by the routine performance of the third eyelid flap.Discussion: The delay in seeking veterinary care and the application of spray based on oxytetracycline and hydrocortisone aggravated the lesion, since the corticosteroid delays corneal healing and favors the aggravation of the lesion. After desensitization of the cornea, the animal allowed eye manipulation and it was possible to observe the lesion and choose the best treatment, with option for the third eyelid flap because it is a simple and fast technique, does not require special equipment or materials, ideal for performed in the field and is widely used in the treatment of injuries involving the cornea and, besides that, helps to contain corneal perforation and protect the ocular surface. Corneal debridement was also performed to remove necrotic debris and improve drug action, in addition to using broad-spectrum antibiotic eye drops until complete regeneration of the lesion. Twenty-one days after the surgical procedure, the patient had no ocular discomfort, the flap was removed and no changes in the corneal surface were observed. The treatment was considered satisfactory for the healing of the corneal ulcer, guaranteed the esthetics and visual function of the sheep.Keywords: keratitis, surgery, ciprofloxacin, ocular, ruminant

Environmental Screening of Fonsecaea Agents of Chromoblastomycosis Using Rolling Circle Amplification

Chromoblastomycosis is a chronic, cutaneous or subcutaneous mycosis characterized by the presence of muriform cells in host tissue. Implantation disease is caused by melanized fungi related to black yeasts, which, in humid tropical climates, are mainly members of the genus Fonsecaea. In endemic areas of Brazil, F. pedrosoi and F. monophora are the prevalent species. The current hypothesis of infection is traumatic introduction via plant materials, especially by plant thorns. However, isolation studies have demonstrated a low frequency of the agents in environmental substrates. The present study aimed to detect F. pedrosoi and F. monophora in shells of babassu coconuts, soil, plant debris, and thorns from endemic areas of chromoblastomycosis in Maranhão state, northern Brazil, using Rolling Circle Amplification (RCA) with padlock probes as a new environmental screening tool for agents of chromoblastomycosis. In addition to molecular screening, the environmental samples were analyzed by fungal isolation using mineral oil flotation. The limit of detection of the RCA method was 2.88 × 107 copies of DNA per sample for the used padlock probes, indicating that this represents an efficient and sensitive molecular tool for the environmental screening of Fonsecaea agents. In contrast, with isolation from the same samples using several selective methods, no agents of chromoblastomycosis were recovered

Professores e Alunos: o engendramento da violência da escola

The school violence engendering is partially analyzed, considering the violence production in the school environment. This is a bibliographic research with quantitative and qualitative approach. Sources: 77 theses and 15 dissertations carried out in Brazil (2007 to 2012). Data collection and organization: Content Analysis. Main reference: Bernard Charlot and Pierre Bourdieu. Results: the sources showed that Brazilian teachers participate effectively in the school violence engendering, contributing to violence production in the school environment. The students are the main victims. The teacher is less affected by physical and verbal violence. The symbolic power is the most perpetrated by the teacher against the student. The school also plays a major role in it.Analisa-se o engendramento de uma face da violência da escola, tendo em vista a produção da violência em espaço escolar. Pesquisa bibliográfica quanti-qualitativa. Fontes: 77 dissertações e 15 teses produzidas no Brasil (2007 a 2012). Coleta e organização dos dados: Análise de Conteúdo. Fundamentação base: Bernard Charlot e Pierre Bourdieu. Resultados: as fontes apontaram que professores brasileiros são protagonistas na constituição da violência da escola, contribuindo para a produção da violência em espaço escolar. Os alunos são as principais vítimas dessa violência. O professor sofre menos violência física e verbal do que o aluno. A violência simbólica é a mais usada pelo professor contra o aluno. A escola também usa desse expediente

Núcleos de Ensino da Unesp: artigos 2013: volume 2: metodologias de ensino e a apropriação de conhecimento pelos alunos

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP

Seminário de Dissertação (2024)

Página da disciplina de Seminário de Dissertação (MPPP, UFPE, 2022) Lista de participantes == https://docs.google.com/spreadsheets/d/1mrULe1y04yPxHUBaF50jhaM1OY8QYJ3zva4N4yvm198/edit#gid=