Photorefractive keratectomy for myopic anisometropia: a retrospective study on 18 children.

PURPOSE: To evaluate the safety and efficacy of photorefractive keratectomy (PRK) performed under topical anesthesia in children with myopic anisometropia. METHODS: Medium to high unilateral myopia was corrected in 18 patients by PRK. At the time of surgery patients were between 7 and 17 years of age (mean 10 years). All the surgical procedures were performed under topical anesthesia. Pre- and postoperative data regarding visual acuity, eye alignment, and binocular vision were analyzed. RESULTS: The mean correction (SE) obtained with excimer laser was -8.21 D (range: -2.25 to -14.50, SD 3.90). The mean preoperative best spectacle-corrected visual acuity (BSCVA) was 20/70, and the postoperative mean BSCVA was 20/50. A significant difference was observed between the arithmetic mean of the preoperative and postoperative BSCVA (p=0.001). Two of 18 patients improved stereopsis; furthermore, surgery variation strabismus was registered in 33.3% of the patients, following PRK. Patients were followed up for a mean of 39 months. CONCLUSIONS: The treatment of medium to high unilateral myopia with PRK under local anesthesia was found effective and safe in pediatric and adolescent patients. This procedure may improve ocular alignment and stereopsis. Further studies are needed to increase the patient experience and extend follow-up time in order to assess the long-term stability of the RESULTS.

Clinical pharmacokinetics of cefotaxime and penetration in sputum, bone, and prostatic tissue.

Cefotaxime is a new powerful methoxycephalosporin with a broad anti-microbial spectrum, suitable for parenteral administration. In the present study, the concentrations of cefotaxime in serum and in bronchial secretion were determined after intramuscular injection of 1 gm every eight hours for seven days. Subjects were patients suffering from an exacerbation of chronic bronchitis. Serum levels versus time curve were interpreted in terms of a one-compartment open model. Pharmacokinetic parameters after single and multiple doses were investigated. No evidence of significant accumulation was found. Furthermore, a type of in vivo rate of killing with cefotaxime was investigated by evaluating the decrease in the number of colonies in bronchial mucus cultures daily for seven days. In two groups of volunteers who had to undergo surgery, bone and prostatic concentrations of cefotaxime were determined and correlated with serum levels.

Cefoperazone pharmacokinetics and sputum levels after single/multiple i.m. injections in bronchopneumopathic patients and bone, pulmonary and prostatic tissue penetration.

Cefoperazone is a third-generation semisynthetic injectable cephalosporin. It has been reported that cefoperazone has beta-lactamase resistance and quite a broad antimicrobial spectrum against many Gram-positive and Gram-negative microorganisms and most anaerobes. In this study, the pharmacokinetics of cefoperazone were examined in a group of 10 patients suffering from acute exacerbations of chronic bronchitis, with purulent or mucopurulent expectorations. Cefoperazone was administered at the dose of 1 g i.m. every 12 hours. Serum and urinary parameters and the profile of bronchial mucus diffusion were assessed after the first administration and during the whole period of treatment which lasted for 7 days. In a second, third, and fourth group of volunteer patients who had to undergo surgical operations, bone, lung and prostatic penetration of cefoperazone was determined in correlation with serum levels.

Treatment of blepharospasm with botulinum neurotoxin type A: long-term results.

PURPOSE: To describe the long-term efficacy and side effects of treatment of blepharospasm with botulinum neurotoxin type A (Botox). METHODS: A total of 178 patients with blepharospasm were treated by injections of botulinum toxin in the Eye Clinic of the University of Naples from 1980 to 2001. The severity of spasm for each patient was graded on a four-point scale. Duration of improvement was assessed and reported in months. RESULTS: Of 178 cases, 10 were lost to follow-up; of the remaining patients, 93% reported improvement after treatments. The mean duration of improvement was 3.6 months. Twelve patients (76%) who underwent more than 14 treatments maintained stable relief. Three patients (1.7%) had a total remission of spasms. Side-effects were local; none of the 168 patients experienced any systemic or toxic reaction. CONCLUSIONS: Botulinum toxin therapy for blepharospasm can provide long-lasting relief and reduction of spasms in the majority of patients. This therapy has the advantages of being safe, simple, and repeatable.

General principles of pharmacology.

Historically, the clinician was responsible for information about the sources, physical and chemical properties, compounding, and dispensing of drugs. These activities are now delegated to pharmacologists and pharmacists. Today the practitioner's responsibility requires the rational clinical use of therapeutic agents for the prevention, diagnosis, and treatment of disease. Understanding how chemicals act on body homeostasis at the molecular level is the foundation for developing new drugs. Understanding drug actions at the molecular level is also the basis for rational pharmacotherapy. In addition, it has been emphasized repeatedly that drugs seldom exert their beneficial effects without also causing adverse side effects. The inevitability of this therapeutic dilemma lends credence to the statement that there are no safe biologically active agents. In dealing with this certainty, once again, the clinician trained in molecular mechanisms of drug action, principles of disposition, pharmacotherapeutics, and toxicology has the advantage.

Spontaneous resolution of congenital bilateral Brown's syndrome.

We report a case of bilateral Brown's syndrome in a 4-year-old girl. Forced duction testing confirmed the clinical diagnosis. After 7 months we observed a spontaneous resolution in the right eye. The problem in her left eye did not show any significant change over 36 months of follow-up. Various spontaneous resolutions in bilateral cases are reviewed.

Biosynthesis and metabolism of androgenic hormones in cancer of the prostate.

The conversion of dehydroepiandrosterone sulfate into testosterone, delta4-androstenedione, and dihydrotestosterone has been measured in minced prostatic adenocarcinoma tissue from three untreated patients, two patients treated with diethylstilbestrol, and one treated with cyproterone acetate. The results obtained show that in both treated and untreated patients the dehydroepiandrosterone sulfate is actively transformed into dehydroepiandrosterone. The subsequent conversion into testosterone and dihydrotestosterone is less evident and inconstant in untreated patients and is inhibited in patients treated with diethylstilbestrol or cyproterone acetate. No formation of delta4-androstenedione was demonstrated in either treated or untreated patients.

Detection of IgM-anti-toxoplasma antibodies in acute acquired and congenital toxoplasmosis.

The specificity and sensibility of IgM-IFAT for diagnosis of acute acquired and congenital toxoplasmosis may increase after separation of IgM fractions by simple gel filtration method. In the presence of IFA-IgG titers greater than 250 IU/ml with Remington test less than 1/50, specific IgM antibodies to Toxoplasma gondii should be detected by separation. The separation of IgM seems a necessary step for detecting IgM antibodies by IgM-IFA in the newborn sera.

An improved method for increasing the sensitivity of direct agglutination test (D.A.T.) to the detection of IgM and IgG anti-toxoplasma antibodies.

The present investigation has shown that the antibody titers obtained by IgG-IFA correlate well with 2-ME-DA (correlation coefficient 0.927, p less than 0.001). These results are obtained when the antibody titers are expressed as IU/ml. Buffer without 2-ME and purification of IgM fractions by simple gel-filtration method seem to be necessary conditions for detecting IgM antibodies by DA test in adult patients. Therefore the DA with these micromodifications has a specificity and sensitivity similar to those of IgG and IgM-IFA tests and would be convenient for laboratories that perform large scale surveys during pregnancy.

The outer capsid glycoprotein VP7 of simian rotavirus SA11 contains two distinct neutralization epitopes.

Seven neutralizing monoclonal antibodies (MAbs) to the rotavirus simian agent 11 were produced. Although displaying variable degrees of haemagglutination-inhibiting activity, they were shown by radioimmunoprecipitation and Western blot analyses to react with the major outer capsid glycoprotein (VP7). In competition binding assays, MAbs defined two distinct VP7 epitopes, which appeared to be close to each other or partially overlapping. In addition, MAbs of the two epitope groups enhanced binding of a broadly reactive, non-neutralizing, MAb specific for rotavirus group antigen.