The Kindred Bonds of Mentally Ill Homeless Persons

While the unraveling of the kinship bond has long been suspected to play a role in the epidemiology of homelessness, the connection between kinship and homelessness has been little studied. Based on a normative analysis of the role of family structure in response to adversity, this article explores the impact of the amount and quality of kinship ties on episodes of homelessness experienced by discharged psychiatric patients in Ohio. Survey data derived from personal interviews with both former patients and their kin indicate more strain in relations with kin of the homeless than the nonhomeless. The strain in the kinship bond appears to emanate from a greater prevalence of chronic disabilities that undermine independent functioning and tax the resources of relatives who choose to remain involved. Consistent with this interpretation, patients with histories of homelessness reported more psychiatric symptoms, more deficits in daily living skills, and more contact with the criminal justice system. In general, patient variables were better able than family variables to differentiate the homeless from the nonhomeless. Nonetheless, the formulation of public policies for reducing the incidence and prevalence of homelessness will surely need to take account of the kinship bond and how it can be strengthened

Polymorphism: an evaluation of the potential risk to the quality of drug products from the Farmácia Popular Rede Própria

Polymorphism in solids is a common phenomenon in drugs, which can lead to compromised quality due to changes in their physicochemical properties, particularly solubility, and, therefore, reduce bioavailability. Herein, a bibliographic survey was performed based on key issues and studies related to polymorphism in active pharmaceutical ingredient (APIs) present in medications from the Farmácia Popular Rede Própria. Polymorphism must be controlled to prevent possible ineffective therapy and/or improper dosage. Few mandatory tests for the identification and control of polymorphism in medications are currently available, which can result in serious public health concerns

High Incidence of Sympathetic Ophthalmia after Contact and Noncontact Neodymium:YAG Cyclotherapy

Background: Two cases of sympathetic ophthalmia occurring after noncontact neodymium:YAG (Nd:YAG) cyclotherapy have previously been reported. In each case, the patient had undergone filtering surgery in the exciting eye. Although in each case Nd:YAG cyclotherapy was the last surgery performed, the inciting event of sympathetic ophthalmia was unclear. Methods: The authors studied three additional patients who developed sympathetic ophthalmia after Nd:YAG cyclotherapy for glaucoma. Results: Two patients developed sympathetic ophthalmia 4 months after noncontact Nd:YAG cyclotherapy, and 1 patient developed sympathetic ophthalmia 18 months after contact Nd:YAG cyclotherapy. All patients had previous cataract extractions but no filtering surgery in the exciting eye. Clinical features included chronic iridocyclitis, choroidal folds, Dalen-Fuchs nodules, and optic disc edema. Combining these cases with the two previously reported cases, the incidence of sympathetic ophthalmia at our institution thus far is 5.8% (4 of 69) and 0.67% (1 of 150) after noncontact and contact Nd:YAG cyclotherapy, respectively. Conclusions: The incidence of sympathetic ophthalmia after Nd:YAG cyclotherapy is high compared with other ocular procedures. The clinician should vigilantly monitor patients after Nd:YAG cyclotherapy and report additional cases that may have occurred at other institutions

Immunologic and Genetic Markers in Patients With Idiopathic Ocular Inflammation and a Family History of Inflammatory Bowel Disease

Disasters have been predominantly construed as destructive events causing loss of lives, livelihoods and hard-won development. Much less attention has been paid to the constructive nature of disasters as creating potential windows of opportunities to address the overlooked and neglected aspects of disaster risk reduction. Using material from Zimbabwe, this article examines whether the humanitarian crisis, as manifested in the cholera disaster of 2008–2009, created a window of opportunity to accelerate the implementation of the Hyogo Framework for Action. The findings suggest that the humanitarian crisis did not necessarily create a window of opportunity to accelerate the implementation of the framework, owing to (1) inadequate authority and power of the agency responsible for disaster risk reduction, (2) an inadequate legal and institutional framework that outlines clear coordination, accountability mechanisms, resource mobilisation, community participation, and integration of development with regard to disaster risk reduction and (3) a lack of an integrated evidence-based approach to advocate disaster risk reduction in Zimbabwe.https://doi.org/10.4102/jamba.v5i1.99https://doi.org/10.4102/jamba.v5i1.10

Immunologic markers as potential predictors of systemic autoimmune disease in patients with idiopathic scleritis.

PURPOSE: To determine the clinical value of serological testing in patients with idiopathic scleritis. DESIGN: Retrospective case series. METHODS: Medical records of patients with scleritis seen at an institutional referral center over an 11-year period were reviewed. RESULTS: Of 119 patients with scleritis seen at the University of Illinois Uveitis Clinic, 91 (76.5%) patients had no known etiology at initial presentation. Seventy of the 91 patients were tested for rheumatoid factor (RF), 19 (27.1%) of whom had a positive result. Ten (52.6%) of these RF positive patients were subsequently, diagnosed with rheumatoid arthritis (RA) during a mean follow-up of 10.6 months (range, zero to 72 months), whereas only one of 51 (2.0%) RF negative patients developed RA, producing an odds ratio for developing RA in RF positive patients of 55.6 (95% confidence interval (CI) 7.8 to 369.8, P = .00001). Of the 70 patients who were tested for anti-neutrophil cytoplasmic antibody (ANCA), seven (10.0%) tested positive. Three (42.9%) of the ANCA positive patients subsequently developed Wegener granulomatosis (WG), whereas only two of 63 ANCA negative patients (3.2%) developed WG during a mean follow,up of 8.4 months (range, zero to 72 months). The odds ratio for developing WG in patients with idiopathic scleritis and a positive ANCA screen compared with a negative ANCA was 22.9 (95% CI 3.4 to 154.2, P = .006). CONCLUSIONS: The likelihood of patients with idiopathic scleritis developing RA and WG was increased if they had a positive RF or ANCA, supporting the role of immunologic marker testing in patients who present without systemic disease

Etiologies of Chronic Anterior Uveitis at a Tertiary Referral Center over 35 years.

Etiologies of Chronic Anterior Uveitis at a Tertiary Referral Center over 35 years

Immunologic and Genetic Markets in Patients with Idiopathic Ocular Inflammation and a Family History of Inflammatory Bowel Disease

Purpose To evaluate the prevalence of immunologic and genetic markers in patients with idiopathic ocular inflammation and a family history of inflammatory bowel disease. Design Matched case-control study. Methods Patients with a diagnosis of idiopathic ocular inflammation and family history of inflammatory bowel disease who did not have inflammatory bowel disease themselves were identified and matched to control patients with idiopathic ocular inflammation. Serum was evaluated for immunologic markers using Prometheus IBD Serology 7. Genomic DNA was analyzed for single nucleotide polymorphisms (SNP) of the NOD2 gene associated with Crohn disease. Results Fifteen patients with idiopathic ocular inflammation and family history of inflammatory bowel disease were matched to 15 control patients based on age, sex, and race. Eight of 15 patients (53%) with a family history of inflammatory bowel disease had elevated p-ANCA antibody levels compared to 3 of 15 controls (20%) (1-sided P = .04) with a matched analysis odds ratio of 6.0 (1-sided P = .06). Four of 15 patients (27%) with family history of inflammatory bowel disease tested positive for immunologic markers predicting ulcerative colitis, while no control patients tested positive (1-sided P = .06). Carrier rates of NOD2 SNPs did not differ significantly between the test and control groups. Conclusions One-quarter of patients with idiopathic ocular inflammation and a family history of inflammatory bowel disease had immunologic markers predicting bowel disease, and one-half had elevated p-ANCA levels. Prometheus IBD Serology 7 may be useful in the evaluation of selected patients with unexplained uveitis. Ocular inflammation is seen in 6% to 14% of patients with inflammatory bowel disease. [1], [2] and [3] Ocular involvement can include conjunctivitis, keratitis, scleritis, episcleritis, uveitis, optic neuritis, and, less commonly, retinal vasculitis, [2] and [4] and can precede gastrointestinal disease.5 Uveitis is the most common ocular finding in patients with inflammatory bowel disease and is typically classified as chronic anterior uveitis.4 We have previously reported that the prevalence of a family history of inflammatory bowel disease is 3-fold to 15-fold higher in patients with ocular inflammation than in the general population.6 Additionally, 74% of these patients were HLA-B27-negative, suggesting that HLA-B27 is not an adequate diagnostic marker for patients with only a family history of inflammatory bowel disease and idiopathic uveitis.6 This study was conducted in order to identify immunologic markers specific to inflammatory bowel disease in a cohort of patients with idiopathic ocular inflammation and a family history of inflammatory bowel disease. Additionally, we assessed the presence or absence of single nucleotide polymorphisms (SNPs) in the NOD2 gene (also known as CARD15), which is known to be involved in the heritable aspect of Crohn disease

Elevated serum sialic acid in idiopathic acute iridocyclitis

We measured the serum levels of sialic acid in 12 patients with idiopathic acute iridocyclitis and 18 normal controls. Sialic acid levels were significantly elevated in the patients with idiopathic acute iridocyclitis. Since animal studies have shown that intraocular inflammation alone cannot elevate serum level of sialic acid, the results of our study suggest that idiopathic acute iridocyclitis may be a multiorgan disease with systemic effects