Abstract Body

Background: Violence has accompanied the evolution of humanity. It is defined as the “Intentional use of physical force or power, real or in the form of a threat, against oneself, against another person or against a group or a community, which results, or has the possibility of resulting, in injury, death, psychological damage, commitment to development or deprivation”.

Case description: Female, 66 years old, married and domestic. Inserted in a nuclear and uncontrolled family (phase VIII of the Duvall cycle), with APGAR Familiar of Smilkstein of 0 points. With a history of dyslipidemia, epilepsy, spine syndrome with irradiation of pain, malignant breast cancer, depression (with 2 previous hospitalizations for intentional drug intoxication).

She resorted to a scheduled consultation of primary care, with worsening depression and suicidal ideation by a conflicting marital relationship associated with domestic violence in verbal and physical form. On physical examination, no physical signs of aggression were observed. The patient refuses to report her husband and refuses support from Portuguese Association for Victim Support. Thus, it’s decided to refer the patient to the Emergency Department, where she was observed by Psychiatry. At the moment, the patient is under surveillance with Family doctor (FD), Psychiatry and Psychology.

Discussion: In Portugal, domestic violence is a public crime. Its reporting is mandatory for public officials. The case reveals the challenge to the FD in highlighting the breadth of care, proximity to the patient and provision of care centered on the individual and the family.

Abstract Body

1. Background and purpose

Before the raising prevalence of diabetes mellitus, diabetic retinopathy (DR) prevails as one of the most common causes of preventable visual impairment despite established screening programmes, early diagnosis and treatment. Among diabetic patients, one third develops retinopathy and a third of these might have severe retinopathy or macular oedema. Besides impairment on vision and daily activities, RD indicates heightened risk of vascular complications. Our purpose is to sensitize the population to risk factors and protective measures.

2. Methods

Bibliographic search with the term MeSH "Diabetic Retinopathy" in indexed databases, with publication until January 2010

3. Results

The pathophysiology of DR is multifactorial and the main systemic factors involved are poor glicemic control, hypertension and dyslipidemia, and so, these are keystones for DR prevention. The duration of diabetes is one of the most important factors, as it is uncommon the development of DR before puberty and rarely occurs in the first 5 years of disease onset. Evidence showed that the progression rate of retinopathy was significantly reduced by intensive glucose control. Blood pressure control is also a protective factor in systemic management of DR and lowered the need for laser photocoagulation and good control needs to be maintained to keep the risk of complications at a low level. Lipid-lowering measures have also shown to be potentially effective at reducing the risks of DR.

4. Conclusions

Certain diabetic individuals are at higher risk of DR and visual impairment. Clinical determinants and predictors are prognostic markers and can assist physicians and patients in developping an effective risk-based plan.

Abstract Body

Background: Violence has accompanied the evolution of humanity. It is defined as the “Intentional use of physical force or power, real or in the form of a threat, against oneself, against another person or against a group or a community, which results, or has the possibility of resulting, in injury, death, psychological damage, commitment to development or deprivation”.

Case description: Female, 66 years old, married and domestic. Inserted in a nuclear and uncontrolled family (phase VIII of the Duvall cycle), with APGAR Familiar of Smilkstein of 0 points. With a history of dyslipidemia, epilepsy, spine syndrome with irradiation of pain, malignant breast cancer, depression (with 2 previous hospitalizations for intentional drug intoxication).

She resorted to a scheduled consultation of primary care, with worsening depression and suicidal ideation by a conflicting marital relationship associated with domestic violence in verbal and physical form. On physical examination, no physical signs of aggression were observed. The patient refuses to report her husband and refuses support from Portuguese Association for Victim Support. Thus, it’s decided to refer the patient to the Emergency Department, where she was observed by Psychiatry. At the moment, the patient is under surveillance with Family doctor (FD), Psychiatry and Psychology.

Discussion: In Portugal, domestic violence is a public crime. Its reporting is mandatory for public officials. The case reveals the challenge to the FD in highlighting the breadth of care, proximity to the patient and provision of care centered on the individual and the family.