Risk factors for blindness in patients with open-angle glaucoma followed-up for at least 15 years

Purpose: To determine the proportion of blindness and investigate the relationships between risk factors based on clinical characteristics and development of blindness in patients with primary open-angle glaucoma (POAG) treated for at least 15 years. Methods: A retrospective observational chart review was performed with 403 patients referred to a tertiary level hospital, each with a diagnosis of primary open-angle glaucoma, treated for at least 15 years. Blindness attributable to glaucoma was defined based on visual acuity and/or visual field tests. Variables considered to be possible risk factors for blindness were evaluated using odds ratio (OR), confidence interval (95% CI), and univariate and multivariate analyses. Results: Thirty-one patients became blind [13/53 (24.5%) - unilaterally and 18/53 (34%) - bilaterally] during the follow-up period of treatment (19.5 +/- 4.6 years, range 15-31 years). Multivariate statistics with regression analysis revealed that persistency on initial therapy <= 6 months was significantly associated with blindness, both unilateral (OR: 8.4; 95% CI: 1.3-56.4) and bilateral (OR: 7.2; 95% CI: 1.3-39.6). Other potential factors such as race, age, gender or number of medications were not associated with blindness. Conclusion: Blindness from primary open-angle glaucoma was not uncommon in this population of treated patients after the long follow-up period proposed. Persistence rates with the first therapy, as measured by a medical decision to change, were low. Persistence <= 6 months was statistically associated with the development of unilateral and bilateral blindness from glaucoma.

Risco de persistência na conduta infracional em adolescentes: estudo exploratório

A literatura internacional é consistente em apontar fatores de risco fortemente associados à persistência do comportamento infracional em adolescentes. O conhecimento tem servido de base para o desenvolvimento de instrumentos de avaliação de risco de reincidência infracional, com o propósito principal de adequar a medida judicial, o tipo e o nível de intervenção às necessidades do adolescente. O presente estudo teve como objetivo realizar uma investigação exploratória da performance do instrumento Youth Level of Service/Case Management Inventory, fundamentado nos fatores de risco associados à persistência da conduta infracional, em amostra composta de quarenta adolescentes em conflito com a lei, no interior do Estado de São Paulo. Realizada a coleta de dados inicial, após um período de 6 a 12 meses foi feito levantamento no Cartório da Infância e Juventude para verificar registro de novas infrações. Análises estatísticas mostraram a boa capacidade preditiva do instrumento. Outros resultados e limitações do estudo são apresentados e discutidos.