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PurposeTo analyze how ocular surface parameters correlate to presence of pterygium and investigate the possible impact of pterygia on tear film findings and meibomian glands findings.MethodsWe investigated objective parameters of the ocular surface such as conjunctival hyperemia, tear film stability and volume, meibomian gland dysfunction, dry eye disease, corneal topography comparing healthy individuals and correlating with the pterygium clinical presentation.ResultsA total of 83 patients were included. Corneal astigmatism induction was 2.65 ± 2.52 D (0.4–11.8). The impact of pterygium on the ocular surface parameters compared to matched controls was seen in: conjunctival hyperemia (control 1.55±0.39/pterygium 2.14±0.69; p = 0.0001), tear meniscus height (control 0.24±0.05 mm/pterygium 0.36±0.14mm; p 0.0002), meiboscore lower eyelid (control 0.29±0.64/pterygium 1.38±0.95; p 0.0001) and meiboscore upper eyelid (control 0.53±0.62/pterygium 0.98±0.75; p = 0.0083). We found a high number of pterygium patients (88%) presented meibomian gland alterations. Interestingly, meibomian gland loss was coincident to the localization of the pterygium in 54% of the upper and 77% lower lids.ConclusionPterygium greatly impacts on ocular surface by inducing direct alterations in the pattern of meibomian glands besides corneal irregularities, conjunctival hyperemia and lacrimal film alterations, inducing significant symptoms and potential signs of dysfunction.

Background Antiangiogenic therapy has proved to be an important therapeutic tool for many retinal vascular diseases; however, its availability is limited in developing countries. This study sought to describe the bevacizumab vial sharing process and to evaluate the impact of this repackaging system on the costs incurred in a Brazilian public hospital. Method This retrospective study compared the number and costs of intravitreal antiangiogenic injections approved via court order in the first year of the study (2015) to the number and costs of the bevacizumab injections provided through the use of vial sharing in the second year of the study (2016). Vial sharing consists of the traditional process used to repackage bevacizumab; in this case, however, the drug samples used were the residual volume from the preparation of bevacizumab for oncology patients. The hospital adhered to the guidelines established by the Brazilian Health Surveillance Agency (ANVISA). Results In the first year of the study and using medication obtained through court orders, 550 intravitreal injections were performed in the ophthalmology ambulatory care center. Based on local pricing tables, the total cost of the medication was BRL$1,036,056.25 (USD$267,546.58), and the average cost of each application was BRL$1883.74 (USD$486.45). In the second year of the study, 1081 intravitreal applications were performed at the same hospital using doses obtained through bevacizumab vial sharing. The total cost was BRL$21,942.49 (USD$5663.30) and the per-unit cost was BRL$20.30, or USD$5.23 (a savings of 97.88%). Conclusion This study found that bevacizumab vial sharing led to a significant reduction in public health care costs associated with antiangiogenic treatment and increased the availability of the drug to public health care patients. These results can be extrapolated to other types of drugs and health care systems.

2627 Purpose: To analyze how ocular surface parameters correlate to pterygium and investigate the 28 possible impact on tear film and meibomian glands. Methods: we investigated objective parameters 29 of the ocular surface such as conjunctival hyperemia, tear film stability and volume, meibomian gland 30 dysfunction, dry eye disease, corneal topography comparing healthy individuals and correlating with 31 the pterygium clinical presentation. Results: A total of 83 patients were included. Corneal 32 astigmatism induction was 2. 65 ± 2.52 D (0.4-11.8). The impact of pterygium on the ocular surface 33 parameters compared to matched controls was seen in: conjunctival hyperemia (control 34 1.55±0.39/pterygium 2.14±0.69; p=0.0001), tear meniscus height (control 0.24±0.05 mm/pterygium 35 0.36±0.14mm; p 0.0002), meiboscore lower eyelid (control 0.29±0.64/pterygium 1.38±0.95; p 36 0.0001) and meiboscore upper eyelid (control 0.53±0.62/pterygium 0.98±0.75; p=0.0083). We found 37 a high number of pterygium patients (88%) presented meibomian gland alterations. Interestingly, 38 meibomian gland loss was coincident to the localization of the pterygium in 54% of the upper and 39 77% lower lids. Conclusion: Pterygium greatly impacts on ocular surface by inducing direct 40 alterations in the pattern of meibomian glands besides corneal irregularities, conjunctival hyperemia 41 and lacrimal film alterations, inducing significant symptoms and potential signs of dysfunction. 3 42 Introduction 43 Pterygium is a degenerative fibrovascular disease of the ocular surface that can cause 44 symptoms of discomfort, corneal irregularities, aesthetics issues thus compromising visual acuity and 45 patients` quality of life. [1-3] The prevalence of pterygium varies worldwide. Global prevalence was 46 estimated in 10.2% to 12%, reaching higher numbers in tropical regions. Several risk factors have 47 been associated with pterygia, such as geographical latitude, residence in rural areas, old age, race, 48 sex, sun exposure, chronic irritation and inflammation. [4,5] 49 Some studies have pointed tear film and ocular surface changes related to pterygium, but 50 consistent correlations remain unknown. [6-9] Although numerous theories have been implicated in 51 pterygium pathogenesis, including ultraviolet radiation exposure, viral infection, oxidative stress, 52 genetic issues, inflammatory mediators, extracellular matrix modulators, it remains controversial as 53 well as its impact on ocular surface homeostasis and function.[10] And a better understanding of the 54 pathophysiological mechanisms associated with pterygium, the morphological alterations on the 55 ocular surface and functional impact may contribute to specific approaches and more effective 56 therapeutic proposals for this common ocular condition. 57 This study aimed to evaluate how ocular surface parameters correlate with pterygium clinical 58 presentation and its impact on ocular surface structures and homeostasis. 4 59 Materials and Methods 60 The present study had a transversal, obs...

O aborto faz parte da realidade brasileira e deve ser abordado pelos programas públicos de saúde e enfatizado na formação dos profissionais da área. Este trabalhou buscou identificar e comparar o conhecimento da legislação brasileira relativa ao aborto entre estudantes de curso médico, verificar entre os concluintes as abordagens recebidas com relação ao aborto durante o curso e discutir possíveis implicações para o desempenho profissional. A pesquisa foi realizada mediante a aplicação de um questionário estruturado a todos os estudantes do 1º e 6º ano do curso médico (90 alunos em cada turma) de uma Universidade pública do estado de São Paulo, e os dados foram analisados com o pacote estatístico SPSS, versão 17. Verificou-se que não há diferença entre o conhecimento dos alunos do 1º e 6º ano com relação aos casos previstos na legislação brasileira para a prática do aborto. Embora 87% dos concluintes mencionem ter recebido algum conteúdo a respeito do tema aborto, 72,7% não consideravam que esse conteúdo era suficiente para o conhecimento que deveriam ter na formação médica. Considera-se fundamental revisitar a formação médica que, além do conhecimento técnico, deve incorporar questões do direito sexual e reprodutivo na saúde da mulher.