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Wir gehen wir in diesem Text der Frage nach den Zusammenhängen zwischen Supervision und ethischer Reflexion in Care-Organisationen nach. Dabei gehen wir von zwei Fallbeispielen aus dem Krankenhaus – eines aus der Supervisionspraxis und eines aus einem partizipativen Forschungsprojekt – aus. Wir definieren zunächst das Beratungsformat Supervision, halten fest, dass Supervision einen ethischen Rahmen braucht und beschreiben die ethischen Richtlinien als Teil des Kontrakts. Konflikte sind in Care-Organisationen und in sorgenden Beziehungen unvermeidbar, unter anderem, weil diese Beziehungen asymmetrisch sind und weil ihnen Widersprüche zugrunde liegen. Die daraus resultierenden Dilemmata werden oft genug an die Supervision herangetragen, damit ist Supervision ein Ort der ethischen Reflexion. Wir beschreiben Verbindendes und Trennendes zwischen Supervision und ethischer Fallbesprechung. Für jeden dieser ethischen Reflexionsorte ist es von Bedeutung, explizit zu machen, auf welchen ethischen Grundlagen sie beruhen. Wir beziehen uns in unserem Text und in Bezug auf die Supervision auf die feministische Care-Ethik mit ihren zentralen Konzepten Vulnerabilität, Achtsamkeit, Bezogenheit und relationale Autonomie, sowie Narrativität, die wir im Text explorieren und beschreiben das Wesen von Caring Institutions (Tronto 2013). Wir kommen zu dem Schluss, dass Supervision zweifelsohne ein Ort für die Beratung zu ethischen Themen und Fragen sein kann und sehen die Art und Weise, wie mit ethischen Dilemmata und Konflikten im Rahmen von Supervision umgegangen wird, in care-ethischen und prozessethischen Diskursen und Grundlagen verortet. Die Supervision ist daher als ein Ort der care-ethischen Reflexion zu bezeichnen. Sie ermöglicht das Ansprechen und Kommunizieren von strukturellen und organisationalen Problemen und kann so auf mehreren Ebenen dazu beitragen, dass aus einer Care-Organisation eine Caring Institution wird.

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After decades of community mobilizing and a protracted legal battle, Maya villages in southern Belize won a watershed Indigenous land rights victory in the Caribbean Court of Justice in 2015. Since then, the state has criminalized environmental defenders, violated communal land rights, and is argued by Maya activists and alcaldes (village leaders) to be operating in discriminatory bad faith. Accordingly, this Grassroots article casts critical light on a recent flashpoint conflict between the Government of Belize and Maya of Toledo District related to Free Prior and Informed Consent (FPIC). The article is directly informed by both the grounded knowledge of an autonomous movement engaged in frontline resistance, and participatory research that is rooted in a politics and spirit of "accompliceship." The structural analysis we offer from an explicitly anticolonial standpoint is instructive about the historical-imperial processes, social forces, and economic logics that underpin conventional approaches to both "development" and the state's duty to consult local communities. Ultimately, the article reveals the forms of political conflict and environmental degradation that continue to emerge globally at the conjuncture of capitalist development, (postcolonial) state power, and struggles for Indigenous self-determination.er, and struggles for Indigenous self-determination.

Se ha demostrado que la vivencia de soledad social está estrechamente relacionada con el estado de salud de la población. La presente investigación evaluó la prevalencia de la hipertensión arterial y su asociación con la percepción de la soledad social en los habitantes mayores de 55 años de la comunidad Antonio Carrillo. En tal sentido se realizó un estudio analítico de prevalencia, utilizando como población 92 personas, se procedió a interrogar sobre el diagnóstico previo de hipertensión arterial, medición de la presión arterial y posteriormente se aplicó el instrumento de recolección de datos ESTE II. Se obtuvo como resultados que, en los habitantes mayores de 55 años de la comunidad, según las características generales de la población, predominó el sexo femenino (63%); asimismo, la mayoría de los habitantes se encontraron entre un rango de edad de 55 a 64 años (52,2%); según estado civil, prevalecieron los habitantes casados (41,3%); con respecto al nivel educativo la mayoría de los habitantes cursó primaria incompleta (24%) y en relación a la situación laboral predominó la inactividad (76,1%). A su vez, se comprobó que 65,2% de la población era hipertensa y en cuanto a la percepción de soledad social, se evidenció que 68,5% de la población presentaba la misma. Se pudo observar que no hubo asociación estadísticamente significativa entre la presión arterial y la percepción de soledad social (p > 0.05), sin embargo, 68,3% de los habitantes con percepción de soledad social fueron hipertensos.

Digital transformation (DT) refers to the changes in ways of working and business offering caused by adoption of digital technologies in an organization. Small and medium-sized enterprises (SMEs) are struggling with this transformation because of their limited resources and know-how. Thus, SMEs need practical grassroots-level help for DT that allows the companies to analyze where they stand in digitalization, and how they should proceed. This article discusses how SMEs can be supported in their DT by utilizing the DT model consisting of four consecutive phases for supporting companies’ systematic development of digitalization. The article focuses on the first phase of the DT model, positioning, where company’s digitalization status is analyzed in detail, and development ideas are identified. The positioning phase was conducted for 19 SMEs in Northern Ostrobothnia, Finland. The results indicate that the used process and tools were suitable to support SMEs for analyzing their digitalization status and identifying areas for improvement. The DT model and piloted tools have been published as a free-of-charge ApuaDigiin.fi online service to facilitate their widespread use in the future. In this way, public regional business development authors or research organizations can utilize the online service while supporting the digitalization of SMEs.

Objectifs : Déterminer la séroprévalence des infections transmissibles par transfusion de produits sanguin labiles chez les donneurs de sang à l’hôpital Nianankoro Fomba de Ségou. Patients et Méthodes : Il s'agissait d'une étude rétrospective, descriptive effectuée chez les donneurs de sang de Janvier à Décembre 2016 à l’unité de la banque de sang de l’hôpital Nianankoro Fomba de Ségou. Les tests rapides ont été utilisés pour le dépistage des infections recommandées par l’OMS. Résultats : 3941 donneurs ont été colligés. L’âge moyen était de 31,21± 8,7 ans (Extrêmes : 18-60 ans). Le sex- ratio M/F était de 15,63. Les donneurs familiaux et les nouveaux donneurs de sang prédominaient avec respectivement 91,4% et 81%. La séroprévalence du VIH, de l’hépatite B, de l’hépatite C, et de la syphilis était respectivement de 5,30% ; 11% ; 2,40% et 5,40%. La séroprévalence du VIH, de l’hépatite B, de l’hépatite C et de la Syphilis était plus élevée chez les primo-donneurs de sang avec respectivement ; 4,62%, 9,69%, 2,11% et 4,69%. Conclusions : La séroprévalence du VIH, de l’hépatite B, de l’hépatite C et la syphilis est élevée chez les donneurs familiaux et les primo- donneurs d’où l’importance de fidéliser les donneurs bénévoles de sang

Introduction : La sphère oculaire est une localisation rare de la tuberculose. Nous rapportons un cas de cette infection à localisation oculaire chez une jeune fille malienne. Décrire les lésions oculaires au cours d’une infection tuberculeuse. Observation :Il s’agit d’une étude de cas clinique descriptive concernant une fillette de 13 ans, reçue en consultation dans notre service pour rougeur et baisse de l’acuité à l’œil droit évoluant progressivement depuis quelques mois. Malgré les multiples consultations et traitements reçus, les symptômes persistaient et s’aggravaient insidieusement. Dans ses antécédents, nous n’avons pas trouvé de notion de traumatisme oculaire, ni de contage tuberculeux. L’examen ophtalmologique révèle une uvéite antérieure granulomatose avec baisse importante de l’acuité visuelle. L’examen des crachats est négatif, en revanche, l’IDR à la tuberculine est phlycténulaire avec un diamètre d’induration > 35mm. Le traitement anti tuberculeux selon le protocole du Programme Nationale de Lutte contre la Tuberculose (PNLT) a permis une amélioration clinique et fonctionnelle rapide, puis la guérison de la patiente. Conclusion : Le diagnostic de la tuberculose oculaire est difficile dans les pays en voie de développement. Il nécessite la mise à disposition de nouveaux outils diagnostics et une collaboration multidisciplinaire

Objectif: Décrire les caractéristiques épidémiologiques et les modalités de prise en charge préventive des patients. Résultats : Cent cinquante-deux (152) patients ont consulté suite à une exposition au risque d’infection rabique principalement à la suite d’une morsure par un chien (133cas/152). Aucun animal mordeur n’a été mis en observation. La majorité (90%) provenait de Dakar. L’âge médian était de 22 ans [1 - 90 ans] et les hommes étaient les plus touchés avec un sex ratio (H/F) de 1,8. Les blessures de catégorie II étaient les plus fréquentes (100 cas). Près de deux tiers des personnes exposées ont été prises en charge dans les 48 heures. La quasi-totalité des patients avaient bénéficié du protocole Zagreb mais environ 41% d’entre eux avaient abandonné leur prophylaxie post exposition (PPE) en cours de suivi, soit un taux de complétude de 59%. Conclusion : Composante essentielle de la lutte contre la rage, la prophylaxie post exposition doit être améliorée par la sensibilisation et la collaboration avec les services vétérinaires. Tout ceci dans l’esprit du one health ou santé unique ainsi que l’amélioration de l’accessibilité financière des vaccins et des immunoglobulines antirabiques

Objectifs : Evaluer l’impact du counseling pour le dépistage VIH en salle de travail chez les patientes n’ayant pas bénéficié de cette activité lors des CPN. Méthodes et matériels : L’étude s’est déroulée au CSRéf de la commune v de Bamako du 1er janvier au 31décembre 2014. L’échantillonnage était systématique, portait sur toutes les parturientes admises en salle de travail avec une dilatation cervicale à 4cm ou plus et dans le post- partum immédiat avec un âge gestationnel ≥ 28SA ou un poids fœtal ≥1000g. Le test par bandelette a été utilisé après consentement éclairé des patientes .La confirmation a été faite avec l’immunocomb II VIH1 et 2 Bi spot. Résultats :L’étude a rapporté que 4,34% (380) des parturientes n’ont pas fait le dépistage VIH lors du suivi prénatal. En salle d’accouchement, ces 380 parturientes ont bénéficié toutes d’un conseil dépistage volontaire au VIH. Nous avons enregistré 11 cas de refus. Sur les 369 parturientes ayant fait le test, 37 étaient positifs au VIH soit 10%. L’âge moyen était de 27ans ±07 ; non instruite (58,9%) vivant dans un régime polygamique (65,9) ; un suivi prénatal fait (95,12%) ; 93% suivi dans les structures citées PTME. Les antirétroviraux ont été administrés à toutes les mères et aux nouveau- nés vivants. Conclusion : Au regard de la fréquence élevée (10%) des cas positifs dans notre étude, il est nécessaire de poursuivre les activités de Conseil et Dépistage Volontaire en salle d’accouchement pour permettre à l’ensemble des femmes enceintes qui accouchent dans nos structures sanitaires de bénéficier des interventions de la PTME

Le granulome inguinal ou encore appelé donovanose, désigne une maladie provoquée par la bactérie Klebsiella Granulomatis. Il se manifeste par des ulcères indolores au niveau de l'appareil génital. Nous rapportons un cas clinique qui illustre une présentation clinique atypique de la forme des granulomes inguinaux inflammatoires sur hydrocèle bilatérale chez le même patient. Le patient a bénéficié d’une exérèse de lymphœdème plus la cure bilatérale de l’hydrocèle.

L’érysipèle est une dermohypodermite bactérienne aiguë non nécrosante, affectant le plus souvent les membres inférieurs. Les facteurs favorisant sa survenue sont l’existence d’une porte d’entrée (plaies traumatiques négligées, intertrigo), le lymphœdème, l’obésité et la dépigmentation volontaire. La complication la plus fréquente est la récidive. Les autres complications incluent notamment abcédassions, la fasciite et les bactériémies. Nous rapportons une première observation malienne d’érysipèle chez un nourrisson de 8 mois, de sexe féminin, amené en consultation dans l’unité dermatologique de l’hôpital régional de Gao pour l’installation brutale d’une grosse jambe rouge plus notion de fièvre et de frissons. Le diagnostic a été porté devant une tuméfaction du membre inférieur droit rouge, chaude et douloureuse surmontée de bulles tendues associée à une adénopathie inguinale et une leucocytose à l’hémogramme. Un traitement à base d’antibiotique associé à un pansement et le repos a été instauré. L’évolution a été émaillée par la disparition des lésions en dix jours. Le diagnostic positif est fondé sur la clinique renforcé par la recherche de l’origine streptococcique.

O objetivo do presente trabalho é apresentar ao leitor um estado da questão dos problemas metodológicos próprios da pesquisa em História da Tradução. Para começar, delinearei os antecedentes do interesse moderno na História da Tradução. A seguir, situarei a História da Tradução dentro dos Estudos da Tradução, como etapa prévia para assinalar a pertinência do seu ensino e estudo, destacando especialmente a importância desta disciplina para a área. Por último, farei um comentário sobre algumas obras de caráter metodológico, com o fim de assinalar alguns problemas recorrentes na pesquisa em História da Tradução. Como conclusão, apresento uma proposta que contém uma série de passos incontornáveis em toda pesquisa histórica e que pode também ser válida para a história da interpretação, já que, a despeito das diferenças, os dois tipos de história participam das bases comuns da mediação interlinguística.

When a team gets sport successes to level profesional, generates the topics that will be investigated such as the key factors of the succes. The main aim of this study is to analyze the influencie of different factors like the sports context, the social context and training aspects in the success of the Club Baloncesto Conquero through direct perception of thirteen informants associated with the team and the basketball in Huelva. An interview was carried out, related with those factors and the keys to success. The results revealed that workforce planning along the great work of coaching staff, medical staff and physical trainer have been key to the team gets sport successes.

Aim: To examine the characteristics, management and outcomes of cesarean scar pregnancies at a single tertiary obstetric centre over a three-year period. Method: A retrospective study was performed on 8 cases of cesarean scar pregnancy identified between January 2009 and June 2012 from the medical files. Results: The mean gestational age was 58.2 days (35-120). The average time for β-hCG levels to return to normal values after treatment for cesarean scar pregnancy was 3.4 weeks (2-6). The mean number of previous cesarean sections was 1.9 (1-4) and the mean interval time after the last cesarean section was 20 months (10-48). Laparotomy with excision of the sac and primary repair (n=5) and methotrexate (n=3) were the modalities of management. Conclusion: Cesarean scar pregnancy is a potentially life-threatening complication of pregnancy that constitutes a diagnostic and therapeutic challenge. Decision on treatment modality should be determined on individualized basis depending on factors such as gestational age, β-hCG levels, fetal cardiac activity, desire of future fertility and the experience and facilities available.

Aim: Flow mediated dilatation (FMD) is a good sonographic indicator of early atherosclerotic changes which reflects endothelial functions by measuring dilatation of peripheral arteries in response to physical stressors. In this study, we aimed to measure FMD on brachial artery of patients with psoriasis which reflects endothelial dysfunction and compare to that of healthy volunteers. Methods: 30 patients with psoriasis and 31 control subjects matched in terms of age, gender, and demographic characteristics were included to this observational, case-control study. FMD was measured on the nondominant arm of the subjects by using sonographic techniques. Results: The patients and controls were similar in terms of sex, gender, smoking, arterial blood pressure, and body mass index. FMD values, reflecting endothelial functions, were tended to be lower in psoriasis group than healthy controls; however this difference was not statistically significant (7.7 ± 3.1 vs. 8.6 ± 2.8, respectively; p = 0.247). Conclusion: These results support that presence of psoriasis is not a risk factor for future cardiovascular disease development. Prospective, multi-center, large scale studies including control group are needed in order to clarify this issue.

Aim: Laparoscopic cholecystectomy (LC) has become the standard treatment method of cholelithiasis. The chronic cholecystitis and cholelithiasis are the most common pathologies seen in gallbladder disease, accompanying hyperplastic and dysplastic lesions. Methods: 568 laparoscopic cholecystectomy procedures performed between 2008-2013 were analyzed. Clinical details and histopathological data were retrieved from the records. The variety of morphological changes in the diseased gall bladder were correlated with the clinical findings. Chronic cholecystitis and cholelithiasis were put into two groups. A single sample when taken from each neck-corpus and fundus of the gallbladder in the first group, two samples were taken from each site and gallbladder was mapped and examined as a whole in the second group. Results: The sex distribution of the cases was 525 (92.4%) and 43 (7.6 %) male (F/M: 12.1). Median age was 45.5 ± 12.7 years (range: 18-82), median operative time was 60.2 minutes (range: 17-200). Indications for surgery, were chronic cholecystitis in 525 (92.4 %), acute cholecystitis in33 (4.4 %), and gallbladder polyps in 6 (1 %). Acalculous cholecystitis was present in 2 patient(% 0.35) who were operated. Most common pathology noted in our study was chronic cholecystitis seen in 442 cases (%74). Other benign lesions were cholesterosis in 36 (%6) and acute cholecystitis in 28 (%.4). Various other associated lesions and variants of cholecystitis were also encountered. A total of six malignant lesions of gallbladder were observed, which included six cases of incidental adenocarcinomas. By increasing the sample size in gallbladder we saw an increase in the rate of metaplasia (p=0,009), dysplasia (p=0,009), epithelial hyperplasia (p=0.003), and carsinoma (p=0.008) statistically. Conclusion: By increasing the sample size in gallbladder we saw an increase in the rate of metaplasia, dysplasia and carcinoma statistically.

Objectif : L'objectif de cette étude était d'étudier les connaissances, les attitudes, et les pratiques sur les infections buccodentaires des élèves de trois écoles coraniques de Koutiala. Matériel et méthodes : Nous avons réalisé une étude prospective de type descriptif qui a duré six mois allant du 20 Février au 20 Août 2015 sur 300 élèves de trois écoles coraniques de la ville de Koutiala. Les données ont été recueillies à partir des fiches d'enquêtes, saisies et analysées avec le logiciel Epi Info 3.5.4.Résultats : Le sexe masculin a été le plus représenté avec 57,67%. Le sex ratio = 0,73. La tranche d'âge la plus représentée était celle de 8 – 12 ans avec 52% avec un âge moyen de 17 ans et des extrêmes de 8 et 26 ans. Dans notre étude 98,33% des élèves avaient une notion de connaissance sur les infections bucco-dentaires et ces informations étaient données par les parents/ainés dans 60% des cas. Les élèves définissaient la carie comme étant une sorte de cancer ou maladie contagieuse dans 60%des cas. Ils affirmaient que les personnes qui ne se brossaient pas correctement les dents étaient les plus susceptibles de faire la carie dans 93,33% des cas. Dans notre étude 61,33% des élèves disaient que la carie se transmet par le manque d'hygiène buccodentaire (HBD) ; 33,33% des élèves disaient que l'utilisation des brosses à dent + bonne HBD sont les moyens de lutte contre les infections buccodentaires. Les élèves dans 66,67 % des cas conseillaient à leur ami d'aller lui-même au centre de santé et ils pensaient dans 93,33% des cas qu'une bonne HBD prévient les infections buccodentaires. Les élèves disaient se brosser les dents tous les jours dans 98% des cas et ils avaient fait une consultation chez le chirurgien dentiste dans 8,67% des cas. Conclusion : Cette étude montre que les élèves avaient une connaissance sur les infections buccodentaires, les causes et les préventions contre les maladies buccodentaires. Des efforts doivent être fournis en matière de promotion, de prévention, de dépistage et de prise en charge des infections en milieu scolaire et universitaire sans oublier les écoles coraniques tout en intégrant les parents d'élèves dans les processus

Introduction : Les encéphalites aigües sont une cause majeure de morbidité et de mortalité en pédiatrie ; le but de notre étude était d'étudier les aspects épidémiologiques et cliniques des encéphalites aigües chez les enfants âgés de 0 à 15 ans dans le département de pédiatrie du CHU Gabriel Toure. Méthodologie : Il s'est agi d'une étude descriptive sur 12 mois du 1er Janvier au 31 Décembre 2015 au département de pédiatrie du CHU Gabriel Toure Bamako Mali. Tous les dossiers présentant une encéphalite aigüe ont été inclus. Résultats : Ainsi 34 dossiers d'enfants présentant une encéphalite aigüe sur un total de 4727 hospitalisés en pédiatrie ont été analysés soit une fréquence de 0,72%. Environ Quarante sept pour cent (47,1%) des enfants avaient un âge compris entre 12 et 59 mois. Le sex- ratio était de 1,8 en faveur des garçons ; la fièvre plus la convulsion étaient présente dans 70,6%, suivie du coma 41,2%. Le taux de mortalité était 6%, et 64,7% ont gardés des séquelles neurologiques. Conclusion : Les encéphalites aigües constituent une cause importante de séquelles neurologiques chez l'enfant à cause des difficultés diagnostiques et de prise en charge

Objective The objective of this study is to analyze the influence of mental illness on the oral health status of psychiatric patients. Materials And Methods We performed a prospective, transverse and descriptive study based on the observation of the oral lesions in the patients received in psychiatric consultation. It took place in the department of Psychiatry of the Center Hospitalo Universitaire of Point G for one month (from June to July 2014). The target population was known psychiatric patients followed and / or hospitalized during the study period. The data were collected from the medical files and a questionnaire and entered and analyzed with the software Epi info fr 6.0. In 54.40% of patients, brushing of teeth was performed once daily and twice daily in 26.10% of cases. Results During the study period, 130 patients were selected according to our inclusion criteria, of which 70.0% were male with a sex ratio of 2.3. The age group 25-34 was the most represented, 31.50%. The majority of our patients had dental abrasion, or 90.80% of the cases. The CAD / D index of our population was 5.22. Halitosis and oral dryness were common in patients with chronic psychosis, respectively 63.5% and 56.90% of cases. Gingivorrhage was observed in 61.10% of patients with chronic psychosis. Conclusion This study shows the high frequency of oral infection in a psychiatric setting, hence the interest of a partnership between mental health professionals and those in the oral cavity. Keywords : Oral infections ; psychiatry ; buccal dryness, CAD index ; Point G Hospital

Aim: Coronary artery ectasia (CAE)is described as the dilatation of all or a portion of the coronary arteries by 1.5 times or more wider than the diameter of adjacent normal coronary artery segment. The incidence of CAE varies between 1.5 to 5%. Although the etiology of CAE has not been enlightened, it is generally considered to be a variant of coronary atherosclerosis. In our study, the association between atherosclerotic risk factors and coronary artery disease in patients with coronary artery ectasia was investigated. Methods: Between January 2008 - May 2012 , 5595 patients were screened retrospectively. Atherosclerotic risk factors were determined in all patients. Patients were grouped as the CAE with coronary artery disease (CAD) and the CAE who had no CAD. Results: CAE was diagnosed in 135 (2.4%) patients. The mean age was 62.2 years and 81.5% were male. 71.1% of the patients had CAD. In CAE patients with CAD, diabetes mellitus (DM) and hypertension (HT) was significantly higher in frequency than CAE patients without CAD. In logistic regression analysis, the presence of DM was increased the risk of CAD 2.59-fold, HT was increased the risk of CAD 3,39-fold. Between the two groups there was no significant difference for other atherosclerotic risk factors. Right coronary arteries were the most common vascular involvement (45.9%). Conclusion: In our study, the frequency of CAE was determined as 2.4%. DM and HT which are well-known risk factors for CAD, were seen more frequently in CAE patients with CAD.

Mushroom poisoning is still a serious health problem for Turkey. The mushroom species which cause fatal mushroom poisoning have been reported to contain at least 98% alpha-amanitin. The knowledge of the poisonous mushroom species including alpha- amanitin is important for the treatment and prevention of these poisonings. In this review, the mushrooms containig alpha-amanitin and causing deadly mushroom poisinings were listed and given information about their poisonus effects. According to literature, nine poisonous mushroom species which include alpha-amanitin have so far been reported from Turkey. These are Lepiota brunneoincarnata; Lepiota castanea; Lepiota helveola; Lepiota subincarnata; Amanita phalloides; Amanita verna; Amanita virosa; Conocybe filaris and Galerina marginata.

Objective: To investigate the prognostic value of the time-dependent changes of hematological parameters in patients with acute organophosphate poisoning. Methods: All patients admitted to emergency departments from 2010 through 2013 due to organophosphate poisoning were enrolled in the study. Demographic data, route of exposure, serum cholinesterase levels, complete blood count results of 5 consecutive days, mechanical ventilation requirement, length of stay in hospital, and outcomes were recorded. Results: Mechanically ventilated patients had higher leukocyte and neutrophil counts than nonventilated patients during the whole follow-up period, and both of them had a trend of decrease in both patient groups. There was no difference between patient groups in terms of lymphocyte counts at day 1, but mechanically ventilated patients had lower lymphocyte counts than nonventilated patients after day 2. Hemoglobin levels had a trend of decrease during the whole follow-up period in both patient groups. Conclusion: The parameters obtained from complete blood count can be used as sensitive follow-up parameters in patients with acute organophosphate poisoning by serial measurement.

Aim: The aim of this study is to detect the adequacy and quality of cervico-vaginal sampling in different age groups. Method: As a screening test, cervico-vaginal smears were obtained from 1179 women was admitted to Obstetrics and Gynecology Clinic of Bozok University Hospital between September 2012 and April 2013. Patients were grouped according to their ages. Patients under 20 years were designated as adolescents, patients between 20 and 44 years represented fertile period and patients 45 years and over were defined as menopausal patients. All the smears were evaluated by the same pathologist. Transformation Zone detection is required for sufficient and appropiate smear sampling. Kruskal Wallis H Tests were used for statistical analysis. Values under 0.05 were accepted as significant. Mann Whitney U test was performed for detecting the origin of significance. Results: Among 1179 patients, 14 of them were adolescents (1.18%), 752 of them belonged to fertile period group (63.78%) and 413 of them were menopausal patients (35.02%). In these groups smear sampling sufficiency and quality detected as; 64.20% in adolescents, 72.90% in fertile period and 59.95% in menopausal patients. Among smears with inflammation, 7 of them were adolescents (50%), 470 of them were in fertile period group (62,50%) and 158 cases were in menopause group (38,25%). Only 1 patient diagnosed as ASC-US (0,08%) and no other premalignant lesion was detected. There was a statistical difference between groups (p

Aim: To investigate the effects of hypertension on the placenta and fetus in pregnancy. Method: 25 hypertensive pregnants, 114 control women, and their infants were included in the study. Results: There was significant correlation between to the body mass index, weight before pregnancy, gestational week, hematocrit, birth weight, placenta size and weight between two groups (p=.002, .003, .003, .004, .000, .050, .032, respectively). The age, gravida, parity, abortus, living child, height, weight gain in pregnancy, hemoglobin, placenta diameter and thickness, volume of clot were similar between groups. Conclusion: As a result, hypertension in pregnancy affects the development of the fetus and placenta as well.

En la primera part de l'article, s'incideix en la importància de l'estudi de les emocions des de la didàctica de les ciències, així com en la necessitat d'establir programes d'intervenció metacognitivos i metaemocionales, tant en l'aprenentatge com en la formació del professorat, perquè alumnes i professors puguin conèixer les seves emocions, controlar-les i autorregularlas. En la segona part, ens centrem en les emocions en el coneixement didàctic del contingut del professorat de ciències, incloent alguns resultats tant del diagnòstic emocional del professorat, segons diferents variables, com del programa d'intervenció de la Universitat d'Extremadura.

Myopericarditis is an inflammatory disease of the both myocardial and pericardial tissues, and resulting from different etiologies. Viral agents such as coxsackie virus type B, adenovirus, and echovirus are the most common leading cause of this disease and it usually occurs following viral upper respiratory tract infections. Although there are different clinical features according to ages groups, some common findings such as tachycardia incompatible with fever, deeply heared heart sounds, and heart failure can be seen. Clinical findings often mimics a myocardial infarction. Diagnosis of this disease is made by the evaluation of the clinical condition, electrocardiography, echocardiography and elevation of the cardiac enzymes. Because it is mortality, discrimination of myopericarditis from myocardial infarction is very important. Herein, we report a 13 year-old-girl with the diagnosis of myopericarditis presenting with chest pain, electrocardiographic changes mimicking myocardial infarction and elevated cardiac enzymes and also aimed to emphasize the importance of accurate diagnosis of this disease.

Mondor’s disease of the penis is a rare entity characterized by thrombosis in the dorsal penile vein. Unlike anxiety resulting from this condition which is conservatively treated, recognizing this disease is quite easy with Doppler ultrasonography. Peyronie’s disease and sclerosing lymphangitis are considered in the differential diagnosis of Mondor’s disease. In this present case report we aimed to present ultrasonography findings and briefly review the literature in a male patient diagnosed with Mondor's disease who admitted with rope like stiffness on the dorsal side of penis mimicking Peyronie's disease.

Aim: The aim of this retrospective study was to evaluate the correlation between histopathological and clinical diagnosis of the endometrial samplings and examine the relevance of the indications. Method: Endometrial biopsies of 495 patients who applied to Bozok University School of Medicine between October 2012 and October 2014 were included this study. Data were obtained from patients file in electronic background and the archives of Department of Medical Pathology. Results: The most frequent indication of endometrial biopsies was abnormal uterine bleeding (283 cases-57.2%). Among the biopsies which were performed with the indication of abnormal uterine bleeding (283 cases), the most common diagnosis was proliferative endometrium (108 cases-38.2%). Among the endometrial biopsies which were done with the clinical diagnosis of cervical polyp, 17 cases (60.7%) were diagnosed as endometrial polyp histopathologically. One case was diagnosed as adenocarcinoma histopathologically. Conclusion: As a result, it is suggested that the gynecologist should be more selective in endometrial biopsy practice.

Objectif : l'objectif de cette étude est de déterminer la prévalence et les facteurs associés à l'insuffisance pondérale chez les personnes vivant avec le VIH sous antirétroviral suivies à Cotonou. Méthodes : Il s'est agi d'une étude transversale, descriptive et analytique. La population d'étude est constituée par les personnes vivant avec le VIH sous antirétroviral, suivies à Cotonou. L'insuffisance pondérale a été définie par un indice de masse corporelle inférieur à 18,5 kg/m2. Résultats : Au total 305 patients ont été inclus. On a noté une prédominance féminine (79%). L'âge moyen était de 38,1± 5,4 ans avec une prédominance des sujets âgés de moins 40 ans (56%). L'insuffisance pondérale est observée chez 24 patients soit une prévalence de 7,87%. Les facteurs associés à l'insuffisance pondérale sont le sexe féminin (p=0,0384), un bas niveau socio-économique (p=0,0009), un apport énergétique bas (p=0,0007), une durée de traitement antirétroviral de moins d'un an (p=0,0075), la mauvaise observance du traitement (p=0,0002), l'analphabétisme (p=0,0000), la présence de lipoatrophie (p=0,0000) et l'absence de lipohypertrophie (p=0,0189). Conclusion : L'insuffisance pondérale persiste chez les personnes vivant avec le VIH à l'ère du traitement antirétroviral hautement actif Mots clés: Insuffisance pondérale, VIH, Cotonou, Bénin

Acute febrile neutrophilic dermatosis also known as Sweet Syndrome is an inflammatory skin disease with an unknown etiopathogenesis, characterized clinically by sudden onset, painful papules, nodules and plaques and histopathologically dense dermal neutrophilic infiltrate. Malignancies, drugs, infections, systemic inflammatory diseases and rarely pregnancy are all considered in the etiology. Here is a patient diagnosed as Sweet Syndrome, with lesions appeared shortly after delivery in her first pregnancy and in the last trimester in her second pregnancy. Her lesions quickly responded to systemic steroid treatment.

Enterococcus species rarely cause bacterial meningitis without predisposing factors such as trauma, brain surgery, etc. In this study, we present a bacterial meningitis case caused by Enterococcus faecalis (E. faecalis) in a 13-year-old male who was found dead at home. One hundred and forty two cm tall, 37 kg weight male had admitted to hospital two days after the beginning of complaints such as weakness, headache, swelling of left eye, nausea and vomiting. Body temperature was 37.3 oC, leucocyte count 22100/ mm3, and CRP 71 g/dl at the hospital admission. Antibiotic treatment with amoxicillin/clavulanic acid (625 mg) was given to the patient but he was found dead in his house the day after. In autopsy; yellow-green purulant liquid in left frontoparietal zone, fullness of meningeal vessels and oedema was seen in brain. Isolated bacteria in cerebrospinal fluid (CSF) was identificated as E. faecalis by mini API 32 Strep®. Postmortem microbiological sampling in autopsy and defining etiologic agents is important for rare meningitis cases in which antemortem identification could not be done before death.

OBJECTIVE: here have been tremendous changes in treatment and follow-up of patients with chronic myeloid leukemia (CML) in the last decade. Especially, regular publication and updating of NCCN and ELN guidelines have provided enermous rationale and base for close monitorization of patients with CML. But, it is stil needed to have registry results retrospectively to evaluate daily CML practices. METHODS: In this article, we have evaluated 1133 patients' results with CML in terms of demographical features, disease status, response, resistance and use of second-generation TKIs. RESULTS: The response rate has been found relatively high in comparison with previously published articles, and we detected that there was a lack of appropriate and adequate molecular response assessment. CONCLUSION: We concluded that we need to improve registry systems and increase the availability of molecular response assessment to provide high-quality patient care.

In the present paper we describe the on-land field operations integrated in the TOMO-ETNA experiment carried out in June-November 2014 at Mt. Etna volcano and surrounding areas. This terrestrial campaign consists in the deployment of 90 short-period portable three-component seismic stations, 17 Broadband seismometers and the coordination with 133 permanent seismic station belonging to Italy’s Istituto Nazionale di Geofisica e Vulcanologia (INGV). This temporary seismic network recorded active and passive seismic sources. Active seismic sources were generated by an array of air-guns mounted in the Spanish oceanographic vessel “Sarmiento de Gamboa” with a power capacity of up to 5200 cubic inches. In total more than 26,000 shots were fired and more than 450 local and regional earthquakes were recorded. We describe the whole technical procedure followed to guarantee the success of this complex seismic experiment. We started with the description of the location of the potential safety places to deploy the portable network and the products derived from this search (a large document including full characterization of the sites, owners and indication of how to arrive to them). A full technical description of the seismometers and seismic sources is presented. We show how the portable seismic network was deployed, maintained and recovered in different stages. The large international collaboration of this experiment is reflected in the participation of more than 75 researchers, technicians and students from different institutions and countries in the on-land activities. The main objectives of the experiment were achieved with great success.

La résistance aux antirétroviraux prend une grande ampleur avec la disponibilité de plus en plus des de ces traitements au Mali, surtout dans un contexte où les laboratoires ont des capacités limitées à offrir des outils virologiques pour un suivi optimal.

ABSTRACTKarst voids were encountered during road construction in Yongweol-ri, South Korea. Attempts to determine the extent of the karst voids through drilling was expensive, time-consuming and too dangerous. An electrical resistivity survey was thus carried out to investigate current subsurface geology beneath the proposed road network. This investigation was aimed at imaging karstic voids and detecting areas prone to ground subsidence through the collapse of cavities beneath a road segment overlying such features. A numerical modelling study preceded the field survey to determine whether the electrical resistivity method could identify such features. The field data set consisted of eleven electric profiles acquired using dipoledipole array; electrical resistivity profiles (100 m and 300 m length) were measured using a dipole-dipole electrode configuration and electrode spacing was kept at 5 m to ensure good coverage of the study area. The resistivity data was inverted using 2D and 3D algorithms based on the least squares smoothness constraint technique. The inverted resistivity images provide a clear view of weathered soils, the distribution of weak areas or karst voids and bed rock. Several low resistivity areas were identified and the subsequent drilling of such anomalous areas led to the discovery of several weak zones or clayfilled underground cavities; the drilling results had excellent correlation with the resistivity images. The electrical resistivity imaging result proved precise and extremely efficient in delineating the karstic void investigation and should be taken into account when choosing an investigation technique to be used at complex geological sites. A remedial action plan involving consolidation grouting work has been suggested prior to road construction.RESUMENCuevas kársticas fueron encontrados durante la construcción de unas carreteras en Yongweol-Ri, Corea del Sur. Los intentos para determinar el grado/extensión de las cuevas kársticas a través de perforaciones eran costosos, lentos y muy peligrosos. Así, un estudio de resistividad eléctrica (RE) se llevó a cabo para investigar la geología actual del subsuelo por debajo de la red de carreteras propuesta. La presente investigación fue dirigida a obtener imagen de las cuevas kársticas y la detección de zonas propensas al hundimiento del terreno a través del colapso de las cavidades debajo de un segmento de una carretera encima de las mismas.Un estudio de modelación numérica precedió a la investigación de campo para determinar si el método RE podría identificar tales características. El conjunto de datos de campo constaban de once perfiles eléctricos adquiridos con arreglo dipolo-dipolo; perfiles RE (100 m y 300 m de longitud) fueron medidos usando una configuración de electrodos dipolo-dipolo y la separación entre electrodos se mantuvo a 5 m para garantizar una buena cobertura del área de estudio. Los datos de resistividad fueron invertidos utilizando algoritmos 2D y 3D basados en la técnica mínimos cuadrados amortiguados.Las imágenes de resistividad invertidas proporcionan una vista clara de los suelos erosionados, la distribución de las áreas débiles o de cuevas kársticas y de lecho de roca. Varias zonas de baja resistividad fueron identificadas y la perforación posterior de dichas áreas anómalas llevó al descubrimiento de varias zonas débiles o de cavidades subterráneas llenas de arcilla; los resultados de las perforaciones tuvieron una excelente correlación con las imágenes de resistividad. El resultado del mapa de RE demostró ser precisa y extremadamente eficiente en la delimitación de la investigación de cuevas kársticas y debería tomarse en cuenta cuando se escoja una técnica de investigación para ser usada en sitios geológicos complejos. Ha sido sugerido un plan de acción de medidas correctivas que implica el trabajo de consolidación de anclajes antes de la construcción de carreteras.

La alta diversidad de especies de carnívoros del Perú puede generar problemas al momento de decidir los taxa y temas sobre los que deben dirigirse los esfuerzos de investigación. En este trabajo se evalúa el esfuerzo de investigación en base al número de publicaciones realizadas para cada familia y especie de carnívoro en el Perú. Asimismo, se señalan los vacíos de información relevantes para la conservación de cada especie y se presenta la primera evaluación de las prioridades de investigación sobre este grupo animal en el Perú. Se registró 145 publicaciones sobre carnívoros peruanos realizadas desde el año 1943. El número de publicaciones presentó grandes diferencias entre taxa, entre temas estudiados y entre las ecorregiones en las que se realizaron las investigaciones. Según la escala de prioridades propuesta, la especie que debe ser estudiada con mayor prioridad es el coatí andino Nasua olivacea y la de menor prioridad es el ocelote Leopardus pardalis. Los resultados de nuestro trabajo resaltan la urgencia de realizar investigaciones sobre ciertas especies de carnívoros de las que existen pocos datos publicados, tanto a nivel local como global, y que se distribuyen en pocas ecorregiones del Perú. Tanto la escala de prioridades de investigación como la lista de vacíos de información serán de utilidad para guiar esfuerzos logísticos y financieros de investigadores particulares, instituciones privadas y gubernamentales.

En el artículo se exponen los resultados de una investigación realizada en el marco del proyecto FONDECYT 1070795, cuyo objetivo consistió en identificar y caracterizar las nociones que tienen los profesores de nivel medio respecto a las competencias de pensamiento científico y solución de problemas, y la manera en que ambos deben trabajarse en la enseñanza de la química. Con el empleo de una muestra intencional de 33 profesores, seleccionados de un total de 117 que se incorporaron a otras fases de la investigación y mediante la administración de un cuestionario especialmente diseñado, se logró poner de manifiesto que en ellos predomina una imagen fragmentada y a veces contradictoria de la solución de problemas y de las competencias de pensamiento científico; dicha representación incorpora aspectos de inestimable valor para la formación del estudiante competente, a la vez que incluye otros que en manera alguna favorecen dicha formación en correspondencia con las exigencias actuales. Es notable que competencias de pensamiento científico y solución de problemas no se constituyan como sistema totalmente coherente en la conceptualización de los profesores investigados. Como dato relevante, se constató la oscilante valoración del carácter subjetivo de las situaciones problémicas y los problemas; junto al papel importante que, en opinión de gran parte de los profesores, desempeña el lenguaje, se le otorga un valor oscilante al trabajo con la teoría por parte de los estudiantes; igualmente resulta difusa, y a veces contradictoria, su aproximación a los procesos de algoritmización.

Mohammad Reza Ardalan1, Kamyar Ghabili2, Reza Pourabbas3, Mohammadali M Shoja41Department of Nephrology, Dialysis, and Transplantation, 2Tuberculosis and Lung Disease Research Center, 3Dental and Periodontal Research Center; 4Tuberculosis and Lung Disease Research Center, Tabriz University of Medical Sciences, Tabriz, IranBackground: Periodontal disease has been associated with a number of systemic diseases. A high prevalence of periodontitis among individuals with chronic kidney diseases and end-stage renal disease has been reported. However, no association between periodontal diseases and glomerulonephritis has previously been investigated.Objective: The aim of this study was to assess the severity and possible role of periodontitis in a group of patients with unknown primary glomerulonephritis.Methods: Ten patients with unknown primary glomerulonephritis, and who had a renal biopsy with stable renal function and serum creatinine

Hikmat Abdel-Razeq1, Asem Mansour2, Yousef Ismael1, Hazem Abdulelah11Department of Internal Medicine, 2Department of Radiology, King Hussein Cancer Center, Amman, JordanPurpose: Cancer and its treatment are recognized risk factors for venous thromboembolism (VTE); active cancer accounts for almost 20% of all newly diagnosed VTE. Inferior vena cava (IVC) filters are utilized to provide mechanical thromboprophylaxis to prevent pulmonary embolism (PE) or to avoid bleeding from systemic anticoagulation in high-risk situations. In this report, and utilizing a case study, we will address the appropriate utilization of such filters in cancer patients.Methods: The case of a 43-year-old female patient with rectal cancer, who developed deep vein thrombosis following a complicated medical course, will be presented. The patient was anticoagulated with a low molecular weight heparin, but a few months later and following an episode of bleeding, an IVC filter was planned. Using the PubMed database, articles published in English language addressing issues related to IVC filters in cancer patients were accessed and will be presented.Results: Many recent studies questioned the need to insert IVC filters in advanced-stage cancer patients, particularly those whose anticipated survival is short and prevention of PE may be of little clinical benefit and could be a poor utilization of resources.Conclusion: Systemic anticoagulation can be safely offered for the majority of cancer patients. When the risk of bleeding or pulmonary embolism is high, IVC filters can be utilized. However, placement of such filters should take into consideration the stage of disease and life expectancy of such patients.Keywords: anticoagulation, bleeding, chemotherapy

Michael Pazianas1, Cyrus Cooper1,2, Yiting Wang3, Jeff L Lange4, R Graham G Russell1,51The Botnar Research Centre, Oxford University, Oxford, UK; 2MRC Epidemiology Resource Centre, University of Southampton, Southampton, UK; 3Warner Chilcott Pharmaceuticals, USA; 4Procter & Gamble Company, Cincinnati, OH, USA; 5The Mellanby Centre for Bone Research, Sheffield University, Sheffield, UKBackground: Epidemiological studies investigating a possible association between bisphosphonates and atrial fibrillation (AF) have reported conflicting findings. The objective of our study was to determine whether exposure to oral nitrogen-containing bisphosphonates alendronate and risedronate are associated with increased incidence of atrial fibrillation.Methods: In a retrospective cohort study we analyzed data from three large independent databases, two from the United States (MarketScan® and Ingenix®) and one from the United Kingdom (THIN). 144,548 women, age 50–89, bisphosphonate users during 2002–2005 were compared to 668,891 sex- and age-matched controls (1:4). Our primary outcome measure was new incident atrial fibrillation for up to three years; Cox models adjusted for disease and drug history were used to estimated relative risks.Results: We identified a total of 8,001, 1,984, and 817 AF cases in oral bisphosphonate users and nonusers during 744,340 (MarketScan), 243,898 (Ingenix), and 148,779 (THIN) person-years of follow-up, respectively. Compared to nonusers, overall adjusted relative risk (adjRR) (95% confidence interval [CI]) for AF in oral bisphosphonates users was 0.92 (0.85–0.99; MarketScan), 1.00 (0.87–1.16; Ingenix), and 0.97 (0.79–1.20; THIN); overall adjRR (95% CI) for any cardiac dysrrhythmia for MarketScan was 1.01 (0.98–1.05), Ingenix 1.06 (0.99–1.13), and THIN 0.97 (0.79–1.20).Conclusions: In all three databases from the two countries, the risk of AF or cardiac dysrrhythmia was not increased in postmenopausal women treated for up to three years with oral alendronate or risedronate.Keywords: atrial fibrillation, chemically induced osteoporosis, drug therapy, alendronate or risedronate, bisphosphonates, adverse effects

Yoshiyuki Kitaguchi1, Shunji Kusaka1, Tatsuo Yamaguchi2, Toshifumi Mihashi2, Takashi Fujikado11Department of Applied Visual Science, Osaka University Graduate School of Medicine, Osaka, Japan; 2Topcon Research Institute, Itabashi, JapanPurpose: To investigate the structural changes in the photoreceptors by adaptive optics (AO) fundus imaging and Fourier-domain optical coherence tomography (FD-OCT) in eyes with occult macular dystrophy (OMD).Design: Observational case reports.Methods: Eight eyes of four patients who were diagnosed with OMD were examined. All eyes had a complete ophthalmological examination. Multifocal electroretinograms (mfERGs) were recorded from all eyes. AO and FD-OCT images of foveal photoreceptors were obtained.Results: The best-corrected visual acuity (BCVA) of these eyes ranged from 20/20 to 20/200, and the ocular fundus was normal by conventional ocular examination in all eyes. The amplitudes of the mfERGs were decreased in the foveal area. The inner and outer segment (IS/OS) junction of the photoreceptors in the foveal area was disrupted. The IS/OS junction was intact in one eye with a BCVA of 20/20, and the outer segment layer between the IS/OS junction and retinal pigment epithelium of the FD-OCT images was identified only in the center of the fovea. The AO images showed patchy dark areas in all eyes, which indicated a disruption of the mosaic of bright spots in the fovea.Conclusion: Structural changes of photoreceptors in OMD patients were detected tangentially by FD-OCT and en face by AO.Keywords: Photoreceptors, OMD, images, retinal imaging

Giuseppe Lo Giudice1, Valentina de Belvis2, Marco Tavolato1, Alessandro Galan11San Paolo Ophthalmic Center, San Antonio Hospital, Padova, Italy; 2Paediatric Low Vision Center, Paediatric Rare Eye Disease Center, Department of Paediatrics, University of Padova, ItalyPurpose: To report the effect of subthreshold transpupillary thermotherapy (TTT) in treating serous detachment of the neurosensory retina secondary to chronic central serous chorioretinopathy (CCSC).Methods: Seven eyes from five patients with CCSC, persistent serous detachment of the neurosensory retina and a clinical course of between 12 and 60 months were treated. All eyes received large-spot TTT guided by indocyanine green angiography (ICGA). Subthreshold TTT was performed using an 810 nm diode laser with a spot size of 3.0 mm (power was set at 350 mW). Treatment was applied for 60 seconds to the areas of choroidal hyperfluorescence on ICGA.Results: The mean number of TTT sessions was 1.4 ± 0.5. All eyes were followed up for at least 6 months (mean 9.6 ± 3.2 standard deviation; range 6–12 months). The mean logarithm of the minimum angle of resolution best-corrected visual acuity was significantly better compared with baseline. All TTT-treated eyes had stable or improved vision (P < 0.001). Mean optical coherence tomography (OCT) central foveal thickness was significantly lower in all patients (P < 0.001) compared with pretreatment OCT, with a reduction in subretinal fluid and resolution of serous detachment associated with anatomical fovea restoration. No patient had any treatment-related side effects.Conclusion: Modified subthreshold TTT appears to have a beneficial effect in treating patients with CCSC and persistent neurosensory detachment. The encouraging results and lack of visually significant complications suggest that further investigation is warranted.Keywords: central serous chorioretinopathy, indocyanine green angiography, neurosensory detachment, transpupillary thermotherapy

Meghan E Mcilwain1,2, Jeff Harrison1, Amanda J Wheeler1,3, Bruce R Russell1,21School of Pharmacy, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand; 2Centre for Brain Research, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand; 3School of Human Services, Griffith University, Queensland, AustraliaAbstract: Schizophrenia is a disabling mental illness with a lifetime prevalence of 0.7% worldwide and significant, often devastating, consequences on social and occupational functioning. A range of antipsychotic medications are available; however, suboptimal therapeutic response in terms of psychotic symptoms is common and affects up to one-third of people with schizophrenia. Negative symptoms are generally less amenable to treatment. Because of the consequences of inadequate symptom control, effective treatment strategies are required for people with treatment-resistant schizophrenia. Clozapine has been shown to be more effective than other antipsychotics in treatment-resistant populations in several studies; however, the occurrence of adverse effects, some of which are potentially life-threatening, are important limitations. In addition to those who are intolerant to clozapine, only 30% to 50% experience clinically significant symptom improvement. This review describes the recent evidence for treatment strategies for people not responding to nonclozapine antipsychotic agents and people not responding or only partially responding to clozapine.Keywords: antipsychotic, refractory, clozapine

Tomris Sengor, Sevda Aydin Kurna, Suat Aki, Yelda ÖzkurtFatih Sultan Mehmet Training and Research Hospital, Istanbul, TurkeyBackground: The aim of the study was to examine the clinical success of high Dk (oxygen permeability) piggyback contact lens (PBCL) systems for the correction of contact lens intolerant keratoconus patients.Methods: Sixteen patients (29 eyes) who were not able to wear gas-permeable rigid lenses were included in this study. Hyper Dk silicone hydrogel (oxygen transmissibility or Dk/t = 150 units) and fluorosilicone methacrylate copolymer (Dk/t = 100 units) lenses were chosen as the PBCL systems. The clinical examinations included visual acuity and corneal observation by biomicroscopy, keratometer reading, and fluorescein staining before and after fitting the PBCL system.Results: Indications for using PBCL system were: lens stabilization and comfort, improving comfort, and adding protection to the cone. Visual acuities increased significantly in all of the patients compared with spectacles (P = 0). Improvement in visual acuity compared with rigid lenses alone was recorded in 89.7% of eyes and no alteration of the visual acuity was observed in 10.3% of the eyes. Wearing time of PBCL systems for most of the patients was limited time (mean 6 months, range 3–12 months); thereafter they tolerated rigid lenses alone except for 2 patients.Conclusion: The PBCL system is a safe and effective method to provide centering and corneal protection against mechanical trauma by the rigid lenses for keratoconus patients and may increase contact lens tolerance.Keywords: piggyback contact lens, keratoconus, irregular astigmatism