Cosmetic Therapeutic Keratopigmentation

Bruno Lovaglio Cançado Trindade,1– 3 Isadora Brito Coelho,1 Larissa Lima Magalhães,1 Letícia Arriel Crepaldi,1,2 Frederico Moreira Man Fu,2 Luiza Machado Ribeiro Da Glória2 1Cornea Department, Instituto de Olhos Ciências Médicas, Belo Horizonte, Brazil; 2Faculdade de Ciências Médicas de Minas Gerais, Belo Horizonte, Brazil; 3Cançado Trindade Eye Institute, Belo Horizonte, BrazilCorrespondence: Bruno Lovaglio Cançado Trindade, Cançado Trindade Eye Institute, Rua Manaus 595 – 30.150-350, Belo Horizonte, MG, Brazil, Email [email protected]: To analyze indications safety and potential complications of cosmetic therapeutic corneal keratopigmentation to treat disfiguring aspect of opaque corneas.Methods: Eight eyes of 8 consecutive patients were enrolled in therapeutic corneal keratopigmentation. Surgery was performed using manual technique, and a two-plane corneal dissection was performed. In the deeper pocket, brown pigment was injected to mimic iris color. In the more superficial and smaller pocket, black pigment was used to simulate pupillary opening.Results: Seven out of 8 eyes had significant improvements in cosmesis after surgery. One patient did not have a major improvement due to significant superficial corneal neovascularization. In two eyes, there was pigment fading in the postoperative period, but no additional surgeries were performed. No complications were noted in any of the patients.Conclusion: Therapeutic corneal keratopigmentation can lead to a significant change in ocular appearance and may improve self-esteem and overall life quality. Pigment fading and corneal neovascularization can be a potential problem. Careful patient selection and counseling are important to avoid patients seeking unachievable results.Plain Language Summary: Blindness can lead to a disfiguring appearance caused by corneal opacification. In this study, we analyze the results of performing corneal tattoo to cover the “whiteish” aspect of the cornea and to restore a more natural look for the blind eye. This technique can be performed in eyes with opaque corneas requiring minimal additional surgical skills and can significantly improve patient’s self-esteem.Keywords: keratopigmentation, corneal opacity, corneal tattoo, blind ey

Systematic review of methods used in meta-analyses where a primary outcome is an adverse or unintended event

addresses: Peninsula College of Medicine and Dentistry, St Luke's Campus, University of Exeter, Exeter, UK. [email protected]: PMCID: PMC3528446types: Journal Article; Research Support, Non-U.S. Gov't© 2012 Warren et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.Adverse consequences of medical interventions are a source of concern, but clinical trials may lack power to detect elevated rates of such events, while observational studies have inherent limitations. Meta-analysis allows the combination of individual studies, which can increase power and provide stronger evidence relating to adverse events. However, meta-analysis of adverse events has associated methodological challenges. The aim of this study was to systematically identify and review the methodology used in meta-analyses where a primary outcome is an adverse or unintended event, following a therapeutic intervention

Estresse e Burnout entre residentes multiprofissionais

OBJECTIVE: To identify associations between high-stress and burnout syndrome in multidisciplinary residents from a federal university in Rio Grande do Sul, Brazil. METHOD: This is an analytical, cross-sectional and quantitative study. A socio-demographic questionnaire, the Work Stress Scale and the Maslach Burnout Inventory-Health Services Survey (MBI-HSS) were applied to 37 residents between April and June 2011. P-valuesOBJETIVO: Identificar la asociación entre alto estrés y Burnout en residentes Multiprofesionales de una universidad federal de Rio Grande do Sul. MÉTODO: se trata de un estudio analítico, transversal, cuantitativo. Se aplicaron un formulario de datos socio-demográficos, la Escala de Estrés en el Trabajo y el Maslach Burnout Inventory- Health Services en 37 residentes entre Abril y Junio de 2011. Valores de pOBJETIVO: identificar a associação entre alto estresse e Burnout em residentes multiprofissionais de uma universidade federal do Rio Grande do Sul. MÉTODO: trata-se de estudo analítico, transversal, quantitativo. Aplicaram-se um formulário de dados socio demográficos, a Escala de Estresse no Trabalho e o Maslach Burnout Inventory-Human Services Survey (MBI-HSS) em 37 residentes entre abril e junho de 2011. Valores de

Workloads and strain process in Community Health Agents

ABSTRACT OBJECTIVE To identify the workloads present in the work activities of community health agents (CHAs) and the resulting strain processes. METHOD A descriptive, exploratory, cross-sectional and quantitative study conducted with 137 CHAs. Data were collected through a questionnaire and interview guided by the health surveillance software called SIMOSTE (Health Monitoring System of Nursing Workers), following the ethical codes of the current law. RESULTS In total, were identified 140 workloads involved in 122 strain processes, represented by the occurrence of health problems of the CHAs. The mechanical (55.00%) and biological (16.43%) loads stood out. The most common strain processes were the external causes of morbidity and mortality (62.31%) and diseases of the musculoskeletal system and connective tissue (10.66%). CONCLUSION From the identified overloads, it became evident that all workloads are present in the work process of CHAs, highlighting the mechanical load, represented mainly by external causes of morbidity and mortality that are related to occupational accidents

Occupational stress and work capacity of nurses of a hospital group

The study aimed to evaluate the relationship between occupational stress and the work capacity index of 368 nurses (82.1% of the population) of a Hospital Group. A questionnaire with socio-occupational questions was used as well as two scales: the Job Stress Scale and the Work Capacity Index. The group of nurses was predominantly female (93.2%), worked in care activities (63.9%), had undertaken at least one Postgraduate course (76%) and were satisfied with the unit where they worked (70.5%). Occupational stress was present in 23.6% of the nurses, of these 15.2% presented High Strain work and 8.4% Passive Work. Social Support exercised a significant positive influence on all groups - exposed or not to occupational stress. Regarding the Work Capacity, this was Moderate (28-36 points) for 51.4% of the nurses and Good (37-43 points) for 47.4%. There was no correlation between stress and work capacity.Se trata de un estudio con objetivo de evaluar la relación entre el estrés laboral y el índice de capacidad para el trabajo de 368 enfermeros (82,1% de la población) de un Grupo Hospitalario. Se utilizó un cuestionario con cuestiones socio ocupacionales y dos escalas: la Job Stress Scale y el Índice de Capacidad para el Trabajo. El grupo de enfermeros es predominantemente femenino (93,2%), trabaja en actividades asistenciales (63,9%), posee por lo menos un curso de posgraduación (76%) y está satisfecho con la unidad donde trabaja (70,5%). El estrés laboral está presente en 23,6% de los enfermeros, de estos 15,2% presentan Alta Exigencia en el trabajo y 8,4% Trabajo Pasivo. El Apoyo Social ejerce influencia positiva significativa sobre todos los grupos expuestos y no expuestos al estrés laboral. En cuanto a la Capacidad para el Trabajo, está es Moderada (28-36 puntos) para 51,4% de los enfermeros y Buena (37-43 puntos) para 47,4%. No se encontró correlación entre el estrés y la capacidad para el trabajo.Este estudo teve como objetivo avaliar a relação entre o estresse laboral e o índice de capacidade para o trabalho, de 368 enfermeiros (82,1% da população) de um grupo hospitalar. Utilizou-se um questionário com questões sócio-ocupacionais e duas escalas: a Job Stress Scale e o índice de capacidade para o trabalho. O grupo de enfermeiros era predominantemente feminino (93,2%), trabalhando em atividades assistenciais (63,9%), possuía pelo menos um curso de pós-graduação (76%) e satisfeito com a unidade onde trabalhava (70,5%). O estresse laboral está presente em 23,6% dos enfermeiros, e, desses, 15,2% apresentam alta exigência no trabalho e 8,4% trabalho passivo. O apoio social exerce influência positiva significativa sobre todos os grupos - expostos e não expostos ao estresse laboral. Quanto à capacidade para o trabalho, essa é moderada (28-36 pontos) para 51,4% dos enfermeiros e boa (37-43 pontos) para 47,4%. Não há correlação entre o estresse e a capacidade para o trabalho

Fetal deaths in Brazil: a systematic review

OBJECTIVE To review the frequency of and factors associated with fetal death in the Brazilian scientific literature. METHODS A systematic review of Brazilian studies on fetal deaths published between 2003 and 2013 was conducted. In total, 27 studies were analyzed; of these, 4 studies addressed the quality of data, 12 were descriptive studies, and 11 studies evaluated the factors associated with fetal death. The databases searched were PubMed and Lilacs, and data extraction and synthesis were independently performed by two or more examiners. RESULTS The level of completeness of fetal death certificates was deficient, both in the completion of variables, particularly sociodemographic variables, and in defining the underlying causes of death. Fetal deaths have decreased in Brazil; however, inequalities persist. Analysis of the causes of death indicated maternal morbidities that could be prevented and treated. The main factors associated with fetal deaths were absent or inadequate prenatal care, low education level, maternal morbidity, and adverse reproductive history. CONCLUSIONS Prenatal care should prioritize women that are most vulnerable (considering their social environment or their reproductive history and morbidities) with the aim of decreasing the fetal mortality rate in Brazil. Adequate completion of death certificates and investment in the committees that investigate fetal and infant deaths are necessary

DNA Methods to Identify Missing Persons

Human identification by DNA analysis in missing person cases typically involves comparison of two categories of sample: a reference sample, which could be obtained from intimate items of the person in question or from family members, and the questioned sample from the unknown person-usually derived from the bones, teeth, or soft tissues of human remains. Exceptions include the analysis of archived tissues, such as those held by hospital pathology departments, and the analysis of samples relating to missing, but living persons. DNA is extracted from the questioned and reference samples and well-characterized regions of the genetic code are amplified from each source using the Polymerase Chain Reaction (PCR), which generates sufficient copies of the target region for visualization and comparison of the genetic sequences obtained from each sample. If the DNA sequences of the questioned and reference samples differ, this is normally sufficient for the questioned DNA to be excluded as having come from the same source. If the sequences are identical, statistical analysis is necessary to determine the probability that the match is a consequence of the questioned sequence coming from the same individual who provided the reference sample or from a randomly occurring individual in the general population. Match probabilities that are currently achievable are frequently greater than 1 in 1 billion, allowing identity to be assigned with considerable confidence in many cases