A relação de tutoria é anterior à invenção da linguagem escrita. Desde seu surgimento, ocorreram mudanças em sua estrutura, mas não se perdeu a essência de promover o desenvolvimento do aprendiz. A tutoria é um processo de aprendizado individualizado, numa relação dinâmica, tendo hoje grande importância como ferramenta de ensino em cursos de graduação e treinamentos profissionais. Na educação médica, está relacionada positivamente à percepção de suporte acadêmico, à satisfação com a carreira, à produção científica, à diminuição do risco de burn-out e ao desenvolvimento de relações dentro da profissão. Entretanto, existem limitações, como o pequeno número de tutores preparados, a falta de tempo dos participantes e o restrito apoio institucional. Este trabalho revê os conceitos sobre tutoria, a função dos integrantes e a relação estabelecida entre eles, e avalia a importância, as expectativas e as limitações da tutoria na educação médica, em especial nas escolas de Medicina do Brasil. Foi realizada revisão de artigos científicos do período 2005-2011, no banco de dados PubMed, além de referências citadas nos artigos selecionados.

The management of patients with diffuse invasive conjunctival melanoma focuses on local tumor control and screening for metastasis. Despite the lack of consensus on the benefit of sentinel lymph node biopsy for these neoplasms, the information obtained by histopathology is useful for tumor staging and treatment planning. Due to the lack of evidence of survival improvement, orbital exenteration is being performed with diminishing frequency. We describe a patient with diffuse invasive conjunctival melanoma and lymph node involvement treated by tumor debulking, brachytherapy (custom unshielded radioactive device), and adjuvant ipilimumab who has had a favorable outcome without emergence of local tumor relapse or distant metastasis during 16 months of follow up.

Background/Purpose: To describe a patient with visually symptomatic circumscribed choroidal hemangioma (CCH) treated successfully with intravitreal beta-blocker.Methods: This is an interventional single case report of a 63 year-old man with a juxtafoveal CCH and extensive subretinal fluid (SRF) unsuccessfully treated with intravitreal anti-VEGF. Off-label intravitreal use of metoprolol (50mg/0.05 ml) was then performed. Main outcome measures were resolution or decreased subretinal fluid on OCT, visual stability or improvement, lack of retinal/ocular toxicity.Results: Following 2 intravitreal injections of metoprolol (1 month apart), significant response was observed with decrease of SRF and visual improvement to 20/400 during a 9-week follow-up after the injections.Conclusion: These preliminary findings suggest that intravitreal metoprolol can be a safe alternative treatment for patients with CCH. This off-label therapy could represent another option for patients with this condition.

No abstract

To assess the safety of scleral fixation using the Akreos AO60 intraocular lens (IOL) and Gore-Tex suture. Prospective evaluation of 20 patients who underwent scleral fixation of an Akreos AO60 with Gore-Tex. Patients presenting with aphakia or dislocated IOL without capsular support were enrolled in the study. Main outcome measures included visual acuity, endothelial cell density, and postoperative complications over 6 months of follow-up. Mean ± standard deviation (SD) uncorrected logMAR visual acuity improved from 1.92 ± 0.23 (20/1600 Snellen equivalent) preoperatively to 0.80 ± 0.56 (20/125) at 6 months postoperatively (p < 0.001). Mean ± SD best-corrected visual acuity (BCVA) logMAR was 0.43 ± 0.23 preoperatively and 0.37 ± 0.24 (20/50) at 3–6 months postoperatively (p = 0.312). The mean ± SD endothelial cell density was 1740.50 ± 522.92 cells/mm2 and 1187.19 ± 493.00 cells/mm2 (p < 0.001) pre and postoperatively, respectively. Mean ± SD postoperative spherical equivalent was − 1.12 ± 1.50D. Postoperative complications included exposure of suture in 40% of the patients, hypotony in 15%, ocular hypertension in 10%, transient vitreous hemorrhage in 10%, retinal detachment in 5%, and transient lens opacification in 5%. Scleral fixation with an Akreos AO60 and Gore-Tex appears generally safe. However, given the high incidence of suture erosion observed, the use of scleral flaps or rotating and burying the knots is recommended in order to reduce the risk of this complication.