RESUMO
We report five cases of craniocervical trauma with knives. The occurrence circumstances were common to all injuries. The trauma was caused by a knife during a fight or an intentional injury. All the victims were farmers or ranchers. Their average age was 17 years, with extremes of 13 and 22 years. The cause was most often community conflict. Pre-hospital transport was non-medical for all patients. The average admission time was 3 h and the average management time was 4 h. General anesthesia with orotracheal intubation was the anesthetic technique used. The average length of hospital stay was seven days. The prognosis was overall favorable and the patients returned home without any sequels.
RESUMO
A 35-year-old woman with zonular weakness in the left eye had phacoemulsification with inthe- bag implantation of an acrylic intraocular lens (IOL) and a capsular tension ring. 6 months postoperatively, the patient developed significant visual loss secondary to capsule shrinkage and contraction of the capsulorhexis opening, associated to a slight IOL decentration. Neodymium: YAG laser radial anterior capsulotomy and anterior capsulectomy were performed leading to visual acuity restoration.
Assuntos
Capsulorrexe/efeitos adversos , Contratura/etiologia , Cápsula do Cristalino/cirurgia , Adulto , Feminino , Humanos , Próteses e Implantes , Implantação de PróteseRESUMO
PURPOSE: Prospective randomised study to compare the impact of phacoemusification (PHACO) and small incision cataract surgery (SICS) on endothelial structure (cell density and morphology) and refractive results (visual acuity, induced astigmatism). METHODS: Prospective study of 57 patients (63 eyes) over 20 months (May 2012-January 2014) undergoing surgery by 2 experienced surgeons. We included patients with senile or presenile cataracts, LOCS III class 2, 3 and 4. Patients were randomized into 2 groups based on their birth month (group 1: PHACO [33]; group 2: SICS [30]). All pre- intra- and postoperative data were collected prospectively. The minimum follow-up was 6 months. We used the SPSS 18.0 for statistical analysis. Statistical tests used included the test-t Student, the Anova test, the Mann-Witney non-parametric test and the Khi2 test. A threshold of significance was set at 0.05. RESULTS: The mean preoperative endothelial cell density was 2447.5±225 c/mm2 with no significant difference between the two groups (P=0.207). The mean percentage of hexagonality was 55.5±8.2% in groups 1 and 2. The most significant cell loss was during the first immediate postoperative period for both groups. At Day 15 postoperative, the decrease in cell loss was significant (P<0.001) with a mean loss of 312.9±208.9 c/mm2 (P<10-2). Postoperatively, the mean best-corrected visual acuity was 0.057 log MAR for all of our patients (P=0.170); no patient had an acuity ≤1/10. The mean astigmatism at the conclusion of follow-up was 1.08±0.42 D in group 1 and 1.51±0.55 D in group 2, with a significant difference (P=0.001). CONCLUSION: Both SICS and PHACO give excellent results, both anatomical and refractive. However, SICS appears to be more advantageous than PHACO in terms of speed, cost, and independence from technology, and appears to be better suited to dense cataracts and mass surgery.
Assuntos
Extração de Catarata/métodos , Catarata/terapia , Microcirurgia/métodos , Facoemulsificação/métodos , Idoso , Idoso de 80 Anos ou mais , Catarata/patologia , Extração de Catarata/efeitos adversos , Feminino , Humanos , Complicações Intraoperatórias/etiologia , Masculino , Microcirurgia/efeitos adversos , Pessoa de Meia-Idade , Facoemulsificação/efeitos adversos , Complicações Pós-Operatórias/etiologia , Período Pós-Operatório , Acuidade VisualRESUMO
Whether it appears spontaneously or is induced by therapy, the tumor lysis syndrome is responsible for a massive release of ions and puric bases degradation of products in the circulation exceeding the renal excretion capacity. Some, such as uric acid, xanthine, and calcium phosphate, can precipitate in the renal tubules or parenchyma. It must be known to any practitioner supporting patients with hematologic malignancies, mainly high-grade but also some solid tumors. The 2015 publication of the British recommendations pertaining to patients suffering from hematological diseases should be broadcast. The main goal of treatment is to prevent the occurrence of renal dysfunction associated with heavy morbidity and mortality, either for his own conduct or consequences on obtaining a good tumor response. Some items proposed for the care, whether curative or preventive, should be discussed or detailed, which is the subject of this paper.
Assuntos
Guias de Prática Clínica como Assunto , Síndrome de Lise Tumoral/prevenção & controle , Síndrome de Lise Tumoral/terapia , Adulto , Alopurinol/uso terapêutico , Criança , Neoplasias Hematológicas/complicações , Neoplasias Hematológicas/epidemiologia , Humanos , Incidência , Neoplasias/complicações , Neoplasias/epidemiologia , Neoplasias/terapia , Fatores de Risco , Síndrome de Lise Tumoral/epidemiologia , Síndrome de Lise Tumoral/etiologia , Reino Unido , Ácido Úrico/urinaRESUMO
BACKGROUND: Disydrosis or pompholyx is a chronic and recurrent form of dermatosis that poses a number of therapeutic issues. The etiopathology of the condition is unclear. The aim of this study was to identify factors associated with the palmoplantar and plantar dysidrosis. PATIENTS AND METHODS: This was a prospective case-control study conducted between June 2001 and February 2004 at the University Hospital of Lome (Togo). Each case (palmoplantar or plantar pompholyx) was matched for age (+/- 5 years) and sex with two controls. Examination for tinea pedis was performed in all participants (patients and controls) but mycologic culture alone was done in patients with interdigital-plantar intertrigo. RESULTS: One hundred patients with pompholyx were matched with 200 controls. Mean age was 32.8 +/- 14.8 years in the patient group and 31.4 +/- 14.8 years in the control group. For univariate analysis, the main factors associated with pompholyx were: personal atopy (OR = 12.6; CI95%: 6.4 - 25.1) and familial atopy (OR = 5.8; CI95%: 3.2 - 10.5); history of eczema (OR = 5.4; CI95%: 2.6 - 11.4); hyperhidrosis (OR=4.5; CI 95%: 5.5 - 40.7), sport (OR = 8.8; CI 95%: 3.9 - 20.8); tinea pedis (OR = 15.6; CI 95%: 7.5 - 32.9). In multivariate analysis, atopy (OR = 10.5; CI95%: 8.4 - 20.8) and tinea pedis (OR = 18; CI95%: 10.5 - 25.2) were the only factors associated with pompholyx. Trichophyton rubrum was the most common etiology of tinea pedis in both patients and controls. DISCUSSION: The results of this study show atopy and tinea pedis as factors statistically associated with palmoplantar or plantar pompholyx. However, only cohort studies can determine the precise causal relationship between tinea pedis and pompholyx.
Assuntos
Eczema Disidrótico/etiologia , Adulto , Estudos de Casos e Controles , Coleta de Dados , Eczema Disidrótico/epidemiologia , Feminino , Humanos , Hipersensibilidade/complicações , Hipersensibilidade/epidemiologia , Intertrigo/complicações , Intertrigo/epidemiologia , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Razão de Chances , Prevalência , Estudos Prospectivos , Fatores Socioeconômicos , Fatores de Tempo , Tinha dos Pés/complicações , Tinha dos Pés/epidemiologiaAssuntos
Degeneração Macular , Oclusão da Artéria Retiniana , Doenças Retinianas , Doença Aguda , Angiografia , Angiofluoresceinografia , Humanos , Isquemia/complicações , Isquemia/diagnóstico , Oclusão da Artéria Retiniana/complicações , Oclusão da Artéria Retiniana/diagnóstico , Doenças Retinianas/diagnóstico , Doenças Retinianas/diagnóstico por imagem , Vasos Retinianos/diagnóstico por imagem , Tomografia de Coerência ÓpticaAssuntos
Lentes de Contato , Degeneração Retiniana/diagnóstico , Degeneração Retiniana/terapia , Córnea/patologia , Topografia da Córnea , Humanos , Masculino , Pessoa de Meia-Idade , Miopia/complicações , Miopia/diagnóstico , Miopia/patologia , Miopia/terapia , Degeneração Retiniana/complicações , Degeneração Retiniana/patologia , Esclera/patologia , Índice de Gravidade de Doença , Microscopia com Lâmpada de Fenda , Transtornos da Visão/diagnóstico , Transtornos da Visão/etiologia , Transtornos da Visão/terapiaAssuntos
Ceratite por Acanthamoeba/diagnóstico , Candidíase/diagnóstico , Lentes de Contato/efeitos adversos , Lentes de Contato/microbiologia , Infecções Oculares Fúngicas/diagnóstico , Ceratite/microbiologia , Acanthamoeba/isolamento & purificação , Ceratite por Acanthamoeba/complicações , Ceratite por Acanthamoeba/tratamento farmacológico , Administração Tópica , Antibacterianos/administração & dosagem , Candida albicans/isolamento & purificação , Candidíase/complicações , Candidíase/tratamento farmacológico , Coinfecção/diagnóstico , Coinfecção/tratamento farmacológico , Coinfecção/microbiologia , Infecções Oculares Fúngicas/complicações , Infecções Oculares Fúngicas/tratamento farmacológico , Humanos , Ceratite/diagnóstico , Ceratite/tratamento farmacológico , Masculino , Adulto JovemRESUMO
PURPOSE: To discuss possible factors that could influence the prognosis of primary malignant conjunctival tumors. PATIENTS AND METHODS: We retrospectively analyzed medical records of 79 patients followed for primary malignant conjunctival tumors between January 1997 and July 2011. RESULTS: The mean age at the time of diagnosis was 61.1 years; male/female ratio was 2.59. The mean tumor size was 13.9 mm. The histological type was invasive squamous cell carcinoma in 43 cases (54.4%), epithelial dysplasia in 11 cases (13.9%), carcinoma in situ in 7 cases, conjunctival malignant melanoma in 5 cases, conjunctival lymphoma in 4 cases and other rare tumors in 9 cases. We performed an excisional biopsy with a safety margin in 89.8% of cases, associated with cryotherapy in 46.6% of cases. Enucleation was performed in two cases and orbital exenteration in 5 cases. We noted tumor recurrence in 33.3% of patients after an average period of 9.5 months. Radiation therapy was indicated in 44 cases (55.7%). The mean follow-up of our patients was 42 months. Tumor recurrences were statistically associated with a history of xeroderma pigmentosum (P=0.012), a diagnostic delay more than 11 months (P=0.001), caruncular location (P=0.004), tumor size greater than 10mm (P=0.044), scleral extension (P=0.011), initial treatment limited to excisional biopsy (P=0.033) and histopathologic involvement of the margin of the tumor resection (P=0.008). CONCLUSION: A better understanding of the prognostic factors of primary malignant conjunctival tumors is essential for management and may improve the prognosis of these tumors.