Purpose: To determine the incidence of intraoperative complications of phacoemulsification cataract surgery in a teaching hospital and to compare the intraoperative complication rate between resident trainees and staff ophthalmologists, to ascertain the overall rate of intraocular pressure (IOP) elevation on postoperative day 1 (POD1), and, again, to compare this value between resident trainees and staff surgeons. Setting: Centro Hospitalar São João, Oporto, Portugal. Design: Retrospective study. Methods: This study included eyes submitted for phacoemulsification cataract surgery from January 1, 2017, to December 31, 2017. There were no exclusion criteria. Data collected included the type of surgeon, level of resident training, case complexity, and intraoperative complications. From all noncomplicated surgeries, preoperative IOP and IOP-POD1 were collected. Results: A total of 2937 surgeries were included; 25.6% were performed by resident trainees. The complication rate was 6.3% with resident trainees and statistically significantly lower (3.3%) in staff surgeons. The complication rate of resident trainees did not differ according to their level of residency. There was a significantly increased incidence of IOP-POD1 elevation in the resident trainee group compared with the staff surgeon group. Surgeries performed by resident trainees, a preexisting history of glaucoma, and pseudoexfoliation were significant risk factors for IOP elevation. Conclusions: To our knowledge, this is the first European study comparing the incidence of intraoperative and postoperative complications in cataract surgery performed by resident trainees and staff surgeons. We report a significantly higher rate of intraoperative complications and IOP elevation on POD1 in resident trainees vs staff surgeons.

Rural Brazilian population suffers with several situations of vulnerability, living in poor life conditions and with diffi cult access to healthcare. This study aimed to investigate life conditions and forms of social support in rural settlements in Piauí, regarding cases of Common Mental Disorder (CMD) and abusive use of alcohol. Therefore, a cross sectional study was conducted in two settlements: Santo Antonio (n = 1,060) and Canárias (n = 432), totalising 1,492 participants. The instruments used were a socialdemographic questionnaire; the Self-Reporting Questionnaire (SRQ-20), the Alcohol Use Disorders Identifi cation Test (AUDIT) and the Medical Outcomes Study (MOS). Among the participants who fi tted the inclusion and exclusion criteria to participate in the study (n = 762), it was identifi ed 160 (21%) cases of CMD in the two settlements, with higher prevalence among women and people over 30 years old; and 89 (11.6%) of risky consume, harmful use and alcohol dependency. Regarding social support, participants considered insuffi cient and not enough present in the daily life. The perception of fragility of support in the fi ve evaluated dimensions (material, information, affective, emotional and positive social interaction) is associated with problems in the infrastructure, and in life conditions and it presents important differences between men and women.

Purpose To describe a clinical case of indapamide induced bilateral angle narrowing and acute myopia. Materials and Methods Clinical case report. Results A 37-year-old Caucasian emmetropic man presented to the Emergency Department with complaints of acute-onset bilateral blurry vision, nine days after starting treatment for arterial hypertension with a combination of indapamide and amlodipine. Clinical examination revealed the presence of myopia and appositional closure of the anterior chamber angle. Ultrasound biomicroscopy and mode B ultrasonography disclosed bilateral ciliochoroidal effusion with anterior rotation of the ciliary body and iridocorneal angle narrowing. After intraocular pressure control with brimonidine and timolol, and replacement of indapamide/amlodipine by amlodipine only, the patient was discharged. Complete resolution of the clinical manifestations was observed after three weeks, with no sequelae. Conclusions Indapamide may cause acute myopia and angle closure secondary to ciliochoroidal effusion that are fully reversible after drug withdrawal, as long as timely diagnosis is established. Therefore, indapamide, as well as other sulfonamide-derived drugs, must always be considered in the differential diagnosis of acute myopia and angle closure.

Partimos das problematizações em torno do racismo institucional em que vivem as comunidades quilombolas no Brasil. Para tanto, objetivamos com este estudo: a) identificar o perfil da população, as condições de vida e de acesso às políticas públicas; e b) mapear as linhas de força que compõem as subjetividades e suas histórias de luta. A pesquisa foi realizada numa comunidade quilombola do Estado do Rio Grande do Norte. Os dados foram produzidos a partir da aplicação de questionário sociodemográfico ambiental para os moradores, acompanhado de observação do cotidiano da comunidade e entrevista semiestruturada com as lideranças. Os resultados indicam os efeitos do racismo institucional na produção das iniquidades e desigualdades. Portanto, entendemos o racismo institucional como um bem-sucedido mecanismo da biopolítica ao produzir subjetividades que paradoxalmente sobrevivem entre a captura e a resistência aos propósitos de intervenção e controle social pelas estruturas de poder e domínio do Estado.

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Introduction: To describe a ''triple'' surgical procedure, which combined traumatic cataract extraction by phacoemulsification with gas endotamponade and cyclocryotherapy in the successful treatment of a traumatic cyclodialysis cleft. Methods: A 44-year-old man who suffered severe left eye blunt trauma with an elastic band developed a 4-hour extent cyclodialysis cleft with consequent hypotony. After 7 weeks of persistent hypotonic maculopathy unresponsive to medical treatment, and with an evolving traumatic cataract, the patient underwent cataract surgery combined with intravitreal gas endotamponade (20% SF6) and cyclocryotherapy.Results: Two weeks after the procedure the intraocular pressure increased to 12 mmHg and remained steady during the next 14 months of follow-up. Hypotonic maculopathy resolved and successful closure of the cyclodialysis cleft was confirmed by gonioscopy and ultrasound biomicroscopy. Conclusion:Gas endotamponade and cyclocryotherapy constitute a promising option in the treatment of cyclodialysis clefts unresponsive to medical therapy. In our case, this minimally invasive technique was innovatively combined with cataract surgery. Despite early postoperative intraocular inflammation, a successful outcome was achieved.

Na comemoração dos 30, anos do SUS esse artigo analisa a formação em Psicologia para saúde pública, com foco nas políticas de promoção de equidade. Trata-se de um estudo documental realizado com 21 Projetos Pedagógicos de Cursos de Psicologia no Brasil, que abordam temáticas relacionadas à saúde pública em interface com os estudos de relação de gênero e étnico-raciais. Foram identificadas 111 ementas de disciplinas com discussões sobre saúde pública. Todavia, apenas 7 apresentam interface com relações de gênero e étnico-raciais, que versam sobre: antropologia da saúde em relação ao processo saúde-doença-cuidado; marcadores de gênero, sexualidade, etnia, raça e geracionalidade no debate sobre a determinação social e promoção da equidade e; atenção à saúde dos povos indígenas.

Objetiva-se apresentar um panorama da Atenção Primária à Saúde Mental no Brasil com destaque para as equipes NASF. Utilizou-se dados da Coordenação Nacional de Saúde Mental, do Departamento da Atenção Básica e do segundo e terceiro ciclos do Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção Básica. Observou-se desequilíbrios entre a oferta e a demanda de serviços, pontos de estagnação e distorções no processo de universalização da Atenção Psicossocial, com a existência de vazios assistenciais no território nacional. A capacidade de resposta da Atenção Primária à saúde mental tem ficado comprometida quanto à efetividade, continuidade dos cuidados, equidade e acessibilidade. Nota-se o agravamento desse quadro no cenário atual de crise econômica, social e política e no contexto pandêmico em curso. RESUMOPalavras-chave: Atenção primária à saúde. Saúde mental. Atenção psicossocial. Sistema Único de Saúde (SUS).