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BACKGROUND: Hyperbilirubinemia is a common problem in neonates. The aim of this study was to evaluate the effect of synbiotic in addition to routine phototherapy on the treatment of neonatal jaundice. METHOD: This double-blind clinical trial, was performed on 194, 3-14 days old neonates. Neonates were divided into intervention and placebo groups. The intervention group received 5 drops of oral synbiotic daily along with phototherapy and the placebo group underwent phototherapy plus a placebo. Gestational age, age, weight, sex, initial and daily bilirubin level, frequency of defecation, mode of delivery, and length of hospitalization were assessed. RESULTS: The rate of bilirubin reduction on the first day of admission was significantly higher in the intervention group (2.9±1.81 vs. 2.06±1.93, pâ=â0.002). The mean level of bilirubin on the second (9.8±1.92 vs. 10.88±2.26) and third days (8.06±1.54 vs. 9.86±1.7) was lower in the intervention group (pâ=â0.001). The proportion of discharged patients in the third and fourth days was higher in the intervention group compared to the control (65% vs. 41%, 99% vs. 86.5%, respectively, pâ=â0.001). However, the duration of hospitalization was shorter in the intervention group compared to the control (2.36±0.5 vs. 2.74±0.74, pâ=â0.001). CONCLUSION: Based on our results, daily treatment with 5 drops of synbiotic along with phototherapy can be a safe and effective modality in faster bilirubin reduction, decreasing the hospitalization period and phototherapy. Therefore, it seems that it can be used as an adjunct therapy for neonates with jaundice.
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Hiperbilirrubinemia Neonatal , Ictericia , Simbióticos , Bilirrubina , Edad Gestacional , Hospitalización , Humanos , Hiperbilirrubinemia Neonatal/terapia , Lactante , Recién Nacido , Fototerapia/métodosAsunto(s)
Hemangioblastoma , Neoplasias de la Retina , Enfermedad de von Hippel-Lindau , Angiografía con Fluoresceína , Hemangioblastoma/diagnóstico por imagen , Humanos , Imagen Multimodal , Neoplasias de la Retina/diagnóstico , Enfermedad de von Hippel-Lindau/complicaciones , Enfermedad de von Hippel-Lindau/diagnósticoRESUMEN
BACKGROUND AND OBJECTIVES: Sanjad-Sakati syndrome (SSS; OMIM 241410) is a rare autosomal recessive disorder found almost exclusively in people of Arab origin. It is characterized by congenital hypoparathyroidism, severe prenatal and postnatal growth retardation, and distinct facial dysmorphism. The molecular pathology of this syndrome was shown to be due to a mutation in the tubulin-specific chaperone E (TBCE) gene in chromosomal area 1q42-q43. We aimed to detect and confirm the common mutation responsible for SSS in Tunisian patients and review the literature in order to create a set of clinical diagnostic criteria that might provide appropriate indications for molecular testing. METHODS: Three Tunisian patients with clinical feature of SSS were examined via direct Sanger sequencing of exon 3 of the TBCE gene. RESULTS: Mutation analysis of the TBCE gene revealed the common 12-bp (155-166del) deletion in three new patients, thus raising the number of reported SSS patients to 73. Reviewing the literature, we suggest a scoring system that assigns one point each for major criteria and one half point for minor criteria. INTERPRETATION AND CONCLUSIONS: SSS is an autosomal recessive disorder found in the Middle Eastern population with an estimated incidence of 1 per 40,000-100,000 live births in Saudi Arabia. Reviewing the literature on both its clinical and biochemical characteristics, we suggest for the first time, based on defined major and minor SSS criteria, a clinical scoring system for the diagnosis of SSS. On the one hand, an established scoring system will provide appropriate indications for molecular testing and, on the other hand, reviewed data on SSS will help delineate the phenotype and draw a distinction between differential diagnoses.
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Anomalías Múltiples/diagnóstico , Trastornos del Crecimiento/diagnóstico , Hipoparatiroidismo/diagnóstico , Discapacidad Intelectual/diagnóstico , Chaperonas Moleculares/genética , Osteocondrodisplasias/diagnóstico , Convulsiones/diagnóstico , Anomalías Múltiples/genética , Consenso , Femenino , Marcadores Genéticos , Trastornos del Crecimiento/genética , Humanos , Hipoparatiroidismo/genética , Lactante , Recién Nacido , Discapacidad Intelectual/genética , Masculino , Osteocondrodisplasias/genética , Convulsiones/genética , Eliminación de Secuencia , TúnezRESUMEN
BACKGROUND: The motions of body and tumor in some regions such as chest during radiotherapy treatments are one of the major concerns protecting normal tissues against high doses. By using real-time radiotherapy technique, it is possible to increase the accuracy of delivered dose to the tumor region by means of tracing markers on the body of patients. OBJECTIVE: This study evaluates the accuracy of some artificial intelligence methods including neural network and those of combination with genetic algorithm as well as particle swarm optimization (PSO) estimating tumor positions in real-time radiotherapy. METHOD: One hundred recorded signals of three external markers were used as input data. The signals from 3 markers thorough 10 breathing cycles of a patient treated via a cyber-knife for a lung tumor were used as data input. Then, neural network method and its combination with genetic or PSO algorithms were applied determining the tumor locations using MATLAB© software program. RESULTS: The accuracies were obtained 0.8%, 12% and 14% in neural network, genetic and particle swarm optimization algorithms, respectively. CONCLUSION: The internal target volume (ITV) should be determined based on the applied neural network algorithm on training steps.
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INTRODUCTION: Periorbital burns are an infrequent but potentially devastating injury. This study aimed to elucidate the spectrum of such injuries presenting to a UK burns centre and the outcome achieved in the cases requiring periorbital reconstruction for the restoration of function and form. METHODS: Patients admitted to a UK regional burns centre between January 2005 and January 2011 with periorbital burns were identified from the Patient Administration System (PAS), theatre logs and the International Burns Injury database (IBID). Multiple parameters were assessed using patient notes, ITU and hospital image databases. RESULTS: Over 6 years, 167 patients with facial burns requiring surgery were treated, including 103 patients with eyelid burns. The mean burn size was 33% total body surface area. The eyelid burn depth varied; 67% superficial partial thickness, 17% deep dermal and 16% full thickness. Two patients lost complete vision in one eye, one patient underwent amniotic membrane grafting. In total 16 patients required periorbital reconstruction to maintain eye closure, with 1.8 operations on average per patient. Acute surgery was required in 11 patients, whilst late intervention (>3 months) was needed in 5, 2 patients had both acute and delayed surgery. Of the 5 late intervention patients 4 were treated with full thickness skin grafts and 1 with a Z plasty. Average time for final reconstruction with delayed surgery was 4.5 months. CONCLUSION: The goal in management of periorbital burns is preservation of vision, prevention of future complications and restoration of an acceptable aesthetic outcome. Total visual loss is thankfully rare, but early ophthalmology intervention is vital given the evidence of corneal damage as a brief therapeutic window exists.
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Amnios/trasplante , Quemaduras/cirugía , Quemaduras Oculares/cirugía , Enfermedades de los Párpados/cirugía , Traumatismos Faciales/cirugía , Trasplante de Piel/métodos , Adulto , Unidades de Quemados , Quemaduras/complicaciones , Niño , Estudios de Cohortes , Manejo de la Enfermedad , Quemaduras Oculares/complicaciones , Femenino , Humanos , Masculino , Procedimientos Quirúrgicos Oftalmológicos , Estudios Retrospectivos , Resultado del Tratamiento , Reino Unido , Trastornos de la Visión/etiologíaRESUMEN
INTRODUCTION: Isolated tracheoesophageal fistula without esophageal atresia is a rare congenital malformation. Its etiology is obscure. Diagnosis is difficult but must be made early. PURPOSE: To study the clinical, radiological, and evolutionary sights of this malformation. PATIENTS AND METHODS: We report 4 cases of tracheoesophageal fistula, collected in the department of pediatric surgery of Monastir Hospital and in the neonatology unit of Sousse Hospital during the period between January 2001 and December 2010. RESULTS: The clinical picture consisted in a coughing bout and cyanosis after each feeding. Thoracic and abdominal imaging showed aspiration pneumonia, atelectasis, and gas within the colon. Gastrointestinal opacification demonstrated the fistula in 2 cases. Tracheoscopy visualized the tracheoesophageal fistula in the other 2 cases. Treatment was surgical and consisted in the section-ligation of the tracheoesophageal fistula with pleural interposition in all cases. The course was simple in two cases with a 3-year and 3.5-year follow up, respectively, but the infants died in the other 2 cases. CONCLUSION: Although a rare malformation, tracheoesophageal fistula should be suggested as a diagnosis when respiratory symptoms occur during feeding starting during the neonatal period.
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Fístula Traqueoesofágica/congénito , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Fístula Traqueoesofágica/diagnóstico , Fístula Traqueoesofágica/cirugíaRESUMEN
Data are lacking about the prevalence of psychiatric disorders and suicidal behaviour in incarcerated adolescents in Asia. This cross-sectional study evaluated the prevalence of psychiatric disorders and the prediction of suicidal attempts in 100 incarcerated males aged 12-19 years in Shiraz. Data were collected in face-to-face interview using the Kiddie Schedule for Affective Disorders and Schizophrenia (Farsi version). The mean age was 16.8 (SD 1.3) years and mean age at first imprisonment was 16.0 (SD 1.5) years. Nearly 70% of the adolescents had at least one current psychiatric disorder, the commonest being: conduct disorder (55%), oppositional defiant disorder (48%) and attention deficit hyperactivity disorder (33%); 11% had major depressive disorder and 2% schizophrenia. In all, 20% had self-harmed without intent to kill themselves and 12% had attempted suicide, 50% of whom had tried more than once. In logistic regression analysis only self-harming behaviour and major depressive disorder were significant predictors of attempted suicide.
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Conducta del Adolescente/psicología , Delincuencia Juvenil/psicología , Prisioneros/estadística & datos numéricos , Intento de Suicidio/psicología , Adolescente , Conducta del Adolescente/etnología , Trastornos de Ansiedad/psicología , Trastorno Depresivo/psicología , Humanos , Irán/epidemiología , Delincuencia Juvenil/etnología , Modelos Logísticos , Masculino , Valor Predictivo de las Pruebas , Prevalencia , Reproducibilidad de los Resultados , Factores de Riesgo , Suicidio/psicología , Intento de Suicidio/etnología , Encuestas y Cuestionarios , Adulto JovenRESUMEN
The aim of our study was to assess epidemiological features of neonatal invasive candidiasis in Farhat Hached hospital of Sousse, Tunisia, including incidence, risk factors, mortality, species distribution and antifungal susceptibility. Laboratory data from 1995 to 2010 and medical records of 127 invasive candidiasis cases were reviewed. We tested the susceptibility of 100 Candida sp isolates by using ATB fungus(®) 3 and to fluconazole by using E-test(®) strips. A total of 252 cases of neonatal invasive candidiasis occurred over the study period. The incidence increased 1.8-fold from 1995 to 2006 and decreased fourfold from 2007 to 2010. Candida albicans was the predominant species up to 2006 and a shift in the species spectrum was observed with increase of the non-albicans species mainly C. parapsilosis. The agreement between the ATB Fungus(®) and the E-test(®) for determining fluconazole susceptibility was high. All tested isolates were susceptible to fluconazole, flucytosine, amphotéricine B and voriconazole and the itraconazole resistance rate was 5%. The mortality rate was 63%. The invasive candidiasis incidence increased from 1995 to 2006 and decreased from 2007 to 2010. The spectrum of Candida species and the lack of fluconazole-resistant strains argue for the usefulness of fluconazole as an empiric treatment.
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Antifúngicos/farmacología , Candida/efectos de los fármacos , Candida/aislamiento & purificación , Candidiasis Invasiva/microbiología , Enfermedades del Recién Nacido/microbiología , Candida/clasificación , Candida/fisiología , Candidiasis Invasiva/epidemiología , Candidiasis Invasiva/mortalidad , Femenino , Hospitales , Humanos , Lactante , Recién Nacido , Enfermedades del Recién Nacido/epidemiología , Enfermedades del Recién Nacido/mortalidad , Masculino , Pruebas de Sensibilidad Microbiana , Estudios Retrospectivos , Factores de Riesgo , Túnez/epidemiologíaRESUMEN
UNLABELLED: Fungemia is classically caused by a single species and the detection of more than one species in blood samples is uncommon. We report four cases of mixed fungemia (MF) diagnosed in the parasitology-mycology laboratory of Farhat-Hached hospital in Sousse, Tunisia. The MF episodes occurred in two neonates and two adults suffering from acute myeloid leukemia. Two fungal species were detected concomitantly within the same blood culture in all cases. Species combination was detected by the subculture of the blood culture on Candida ID(®) chromogenic medium in three cases and on Sabouraud agar in one case. Predisposing factors were: indwelling catheters (4/4), broad-spectrum antibiotics (3/4), neutropenia (2/4), exclusive parenteral nutrition (2/4) and Candida colonization (1/4). Patients presented febrile sepsis with no response to broad-spectrum antibiotic therapy in all cases. Outcome under antifungal treatment was favorable in two cases and the two other patients died. CONCLUSION: MF appears similar to the more common monomicrobial fungemia. The use of chromogenic media in routine can improve the detection of MF episodes allowing appropriate antifungal therapy.
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Candida/aislamiento & purificación , Fungemia/microbiología , Geotricosis/microbiología , Geotrichum/aislamiento & purificación , Antibacterianos/uso terapéutico , Antifúngicos/uso terapéutico , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Candida albicans/aislamiento & purificación , Candida tropicalis/aislamiento & purificación , Candidemia/diagnóstico , Candidemia/tratamiento farmacológico , Candidemia/etiología , Candidemia/microbiología , Infecciones Relacionadas con Catéteres/diagnóstico , Infecciones Relacionadas con Catéteres/tratamiento farmacológico , Infecciones Relacionadas con Catéteres/etiología , Infecciones Relacionadas con Catéteres/microbiología , Labio Leporino/complicaciones , Fisura del Paladar/complicaciones , Coinfección , Infección Hospitalaria/diagnóstico , Infección Hospitalaria/tratamiento farmacológico , Infección Hospitalaria/etiología , Infección Hospitalaria/microbiología , Medios de Cultivo , Epidermólisis Ampollosa/complicaciones , Fungemia/diagnóstico , Fungemia/tratamiento farmacológico , Fungemia/etiología , Geotricosis/diagnóstico , Geotricosis/tratamiento farmacológico , Geotricosis/etiología , Humanos , Huésped Inmunocomprometido , Recién Nacido , Leucemia Mieloide Aguda/complicaciones , Leucemia Mieloide Aguda/tratamiento farmacológico , Masculino , Persona de Mediana Edad , Neutropenia/inducido químicamente , Neutropenia/complicaciones , Nutrición Parenteral/efectos adversos , Túnez , Adulto JovenRESUMEN
We report a multispectroscopic, voltammetric and theoretical hybrid of QM/MM study of the interaction between double-stranded DNA containing both adenine-thymine and guanine-cytosine alternating sequences and chloridazon (CHL) herbicide. The electrochemical behavior of CHL was studied by cyclic voltammetry on HMDE, and the interaction of ds-DNA with CHL was investigated by both cathodic differential pulse voltammetry (CDPV) at a hanging mercury drop electrode (HMDE) and anodic differential pulse voltammetry (ADPV) at a glassy carbon electrode (GCE). The constant bonding of CHL-DNA complex that was obtained by UV/vis, CDPV and ADPV was 2.1×10(4), 5.1×10(4) and 2.6×10(4), respectively. The competition fluorescence studies revealed that the CHL quenches the fluorescence of DNA-ethidium bromide complex significantly and the apparent Stern-Volmer quenching constant has been estimated to be 1.71×10(4). Thermal denaturation study of DNA with CHL revealed the ΔTm of 8.0±0.2°C. Thermodynamic parameters, i.e., enthalpy (ΔH), entropy (ΔS°), and Gibbs free energy (ΔG) were 98.45 kJ mol(-1), 406.3 J mol(-1) and -22.627 kJ mol(-1), respectively. The ONIOM, based on the hybridization of QM/MM (DFT, 6.31++G(d,p)/UFF) methodology, was also performed using Gaussian 2003 package. The results revealed that the interaction is base sequence dependent, and the CHL has more interaction with ds-DNA via the GC base sequence. The results revealed that CHL may have an interaction with ds-DNA via the intercalation mode.
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ADN/metabolismo , Modelos Químicos , Piridazinas/metabolismo , Teoría Cuántica , ADN/química , Etidio/análogos & derivados , Sustancias Intercalantes/química , Sustancias Intercalantes/metabolismo , Piridazinas/química , TermodinámicaRESUMEN
Isolates of Narcissus late season yellows virus (NLSYV) were identified from domestic and wild Narcissus populations at incidences of 66 and 49%, respectively. NLSYV was also detected in one plant of Clivea miniata. Comparisons of nucleotide and amino acid sequences of the coat protein genes of NLSYV isolates showed that they formed three distinct phylogenetic groups, including one not seen before. Vallota speciosa virus was detected in one domestic population of Narcissus sp. where it infected 70% of the plants. This is the first report of these viruses in Australia, and of NLSYV infecting C. miniata.
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Narcissus/virología , Enfermedades de las Plantas/virología , Virus de Plantas/aislamiento & purificación , Australia , Proteínas de la Cápside/genética , Genotipo , FilogeniaRESUMEN
OBJECTIVES: To compare efficacy and safety of two regimens of intracervical dinoprostone (Prepidil) in cervical ripening before labor induction at term. PATIENTS AND METHODS: This was a prospective randomized clinical study including 148 patients with single pregnancy, viable fetus at gestational age greater than 36 weeks gestation and a Bishop score less than five, who required induction of labor. Patients were randomised to receive either repeated doses of dinoprostone gel 0.5mg (Prepidil) every 6 hours (group I) or every 12 hours (group II) for maximum three times before inducing labor with Oxytocin. The main outcome was the rate of caesarean sections. RESULTS: The two groups were similar in patient characteristics, indication for labor induction and preinduction Bishop scores. The caesarean rate was lower in group I (20.3%) than in group II (23%); though the difference did not reach statistical difference: p=0.69. Delivery rate in the first 24 hours was significantly higher in group I (62.2%) than in group II (40.5%); p=0.009. Prepidil secondary effects were experienced in 8.1% of patients in group I versus 1.4% in group II; p=0.11. Median umbilical artery pH at birth was 7.232+/-0.47 in group I and 7.294+/-0.58 in group II; p=0.30. Maternofetal infections rate was lower in group I (1.4%) than in group II (2.7%) without significant difference (p=0.56). CONCLUSIONS: Repeated intracervical doses of Prepidil every 6 hours, in cervical ripening before labor induction at term, enables higher delivery rate in the first 24 hours without inducing excess of caesarean sections or maternofetal morbidity when compared to its administration every 12 hours.
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Dinoprostona/uso terapéutico , Trabajo de Parto Inducido/métodos , Adulto , Dinoprostona/administración & dosificación , Dinoprostona/efectos adversos , Femenino , Fiebre/inducido químicamente , Humanos , Concentración de Iones de Hidrógeno , Hipercinesia/inducido químicamente , Oxitócicos/administración & dosificación , Oxitócicos/efectos adversos , Oxitócicos/uso terapéutico , Dolor/inducido químicamente , Embarazo , Tercer Trimestre del Embarazo , Estudios Prospectivos , Seguridad , Vagina/fisiologíaRESUMEN
Congenital epulis or congenital gingival cell tumour is a rare tumour in the neonate. It arises from the gingival mucosa. This benign condition can be life threatening when obstructive. In this report, a case of a male neonate, with features of obstructive congenital epulis arising from both maxillary and mandibular alveolar ridge, interfering with breast-feeding is described. Diagnosis was suspected clinically and confirmed by histology. Outcome was good after prompt surgery.
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Neoplasias Gingivales/patología , Tumor de Células Granulares/patología , Obstrucción de las Vías Aéreas/etiología , Obstrucción de las Vías Aéreas/cirugía , Neoplasias Gingivales/cirugía , Tumor de Células Granulares/cirugía , Humanos , Recién Nacido , MasculinoRESUMEN
A brief review of the evolution of the diffusion boundary layer (DBL) conception inspired by the works of Nernst, Levich and Amatore is presented. Experimental methods for studying the DBL in electrode and membrane systems are considered. The electrochemical behaviour of a CM2 cation-exchange membrane in NaCl and KCl solutions is studied by chronopotentiometry at constant under-limiting current. Chronopotentiometric curves are described theoretically by applying the Kedem-Katchalsky equations in differential form to a three-layer system including the membrane and two adjoining DBLs. The conductance coefficients entering the equations are found by treating the results of membrane characterisation: the electrical conductivity, transport numbers of ions and water, electrolyte uptake, as functions of the equilibrium electrolyte solution. The two-phase microheterogeneous model is used for this treatment resulting in presentation of the conductance coefficients as functions of (virtual) electrolyte solution concentration in the membrane. The steady-state DBL thickness (delta) is found by fitting experimental potential drop at sufficiently high times. It is found that delta is proportional to (Delta c)(-0.2), where Delta c is the difference between the electrolyte concentration in the solution bulk and at the interface. This result differs from the Levich equation, which gives the power equal to -0.25 for Delta c. This deviation is explained by the fact that the theory of Levich does not take into account microscopic chaotic convection motion recently described by Amatore et al. It is shown that the treatment of experimental chronopotentiometric curves with the model developed allows one to observe the role of streaming potential in the membrane. Different mechanisms of streaming potential and their effect on the shape of chronopotentiograms are discussed. A simple analytical solution of Navier-Stokes equations applied to natural convection near an infinite vertical ion-exchange membrane is found. It is shown that the formation of DBL induced by electric current is quasi-stationary. This fact allows the empirical expression found earlier and linking delta with Delta c under steady-state conditions to be used in transient regimes. The numerical solution of the non-stationary Kedem-Katchalsky equations together with this empirical expression results in quantitative description of the potential difference (pd) and delta as functions of time in chronopotentiometric experiments. The comparison of theoretical and experimental chronopotentiometric curves shows an excellent agreement, especially for the part after switching off the current. The reasons of a small deviation observed just before the curves attain steady state under a constant current applied are discussed.
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BACKGROUND: Renal involvement is frequent in neonates with perinatal asphyxia. It is correlated with the severity of neurological damage and seems to worsen the long-term neurological outcome. PURPOSE: The aim of this study was to determine the incidence of renal failure after perinatal asphyxia, to precise the relationship between severity of cerebral damage and renal failure and to evaluate the place of renal damage in the short- and middle-term neurological outcome. POPULATION AND METHODS: We conducted a prospective study including 87 full-term neonates admitted in the neonatology department of F. Hached university hospital in Sousse (Tunisia) and suffering from hypoxic ischemic encephalopathy from 1st January 2003 to 30 June 2005. Renal function was assessed by measuring plasma urea and creatinine at age 48 h. Renal failure was defined by a level of creatinine above 90 micromol/l. Neurologic examination was performed on day 7. The survivors were followed up by the same senior after discharge. RESULTS: During the study period, 87 full-term neonates were admitted for hypoxic ischemic encephalopathy. The degree of neurological impairment was determined according to Sarnat classification: 1st stage 9 neonates (10,3%), 2nd stage 67 (77%) and 3rd stage 11(12,6%). Renal failure involved 15 neonates (17,2%) of whom 10 belonging to the 2nd stage group. Renal function outcome was favorable in all survivors with normalisation of plasma creatinine level between day 5 and day 15. Eight neonates died, of whom 3 with renal failure. Neurologic examination was abnormal in 36 out of 72 (50%) neonates without renal failure and in 9 of the 12 (75%) survivors with renal failure. Among the 12 neonates with renal failure, 7 had abnormal neurologic features at discharge. Neurologic assessment between 6 and 18 months was abnormal in 4/12 (33%) of neonates with renal failure versus 8/72(11%) of neonates without renal failure. CONCLUSION: Transient renal failure is commonly observed in perinatal asphyxia. Renal failure is correlated with neurologic severity. Renal function assessment using creatinine plasma level seems to be correlated with neurologic outcome. However, other tools appreciating renal function, namely tubular function, should be determined earlier in order to predict neurologic outcome after hypoxic ischemic encephalopathy.
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Lesión Renal Aguda/epidemiología , Asfixia Neonatal/complicaciones , Puntaje de Apgar , Cesárea/estadística & datos numéricos , Creatinina/sangre , Parto Obstétrico/métodos , Parto Obstétrico/estadística & datos numéricos , Femenino , Humanos , Incidencia , Recién Nacido , Pruebas de Función Renal , Masculino , Túnez/epidemiología , Urea/sangreRESUMEN
Aortic thrombosis is a rare and severe condition in neonates which often is revealed by ischemia of lower limbs. We report a case of major aortic thrombosis revealed by renal failure, hematuria and dehydration in a 10-day-old girl. Clinical features consisted in hypertension at upper limbs without ischemic signs of the lower limbs. Diagnosis was made using renal Doppler ultrasound. Thrombosis resolved after thrombolytic treatment and anticoagulation using heparin. The case report is followed by a review of the literature dealing with clinical, etiological and therapeutic aspects of neonatal arterial thrombosis.
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Enfermedades de la Aorta/diagnóstico , Trombosis/diagnóstico , Anticoagulantes/uso terapéutico , Enfermedades de la Aorta/tratamiento farmacológico , Deshidratación/etiología , Femenino , Hematuria/etiología , Heparina/uso terapéutico , Humanos , Recién Nacido , Insuficiencia Renal/etiología , Terapia Trombolítica , Trombosis/tratamiento farmacológico , Ultrasonografía DopplerRESUMEN
BACKGROUND: Optic nerve avulsion is an extremely rare occurrence and usually arises in the setting of severe fronto-orbital fractures or penetrating orbital injuries. However, a few cases have been associated with minor injury. OBJECTIVE: To overview the pathophysiology of delayed optochiasmal avulsion following minor ocipital trauma and discuss management options. METHODS: Report of a unique case of a 79-year-old woman who presented with delayed partial expulsion of the right globe and complete optic nerve avulsion following closed head injury to the occiput. CONCLUSION: Antero-posterior distortion of the skull following such a deceleration injury can cause laceration and thrombosis of the pre-chiasmal and pial arteries supplying the optic chiasm. The ensuing ischaemic changes subsequently caused delayed softening of the chiasm and its avulsion. The concomitant retrobulbar haemorrhage and mass effect within the orbit consequently led to the partial expulsion of the globe.
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Traumatismos Craneocerebrales/complicaciones , Traumatismos del Nervio Óptico/etiología , Anciano , Femenino , Humanos , Imagen por Resonancia Magnética , Traumatismos del Nervio Óptico/cirugíaRESUMEN
AIM: To investigate the effect of epiretinal membrane (ERM) peel on patients' health related quality of life (HR-QOL) and to explore the association between self reported HR-QOL and conventional measures of visual function. METHODS: The National Eye Institute 25 Item Visual Function Questionnaire (VFQ-25) and the 36 Item Short-Form Health Survey (SF-36) were self administered by 20 patients before and 4 months following surgery. Preoperative and postoperative data collected included logMAR near and distant visual acuity (VA), contrast sensitivity, and metamorphopsia. Questionnaire scores were compared preoperatively and postoperatively and their correlation with traditional methods of visual function evaluation analysed. RESULTS: Postoperatively there was no significant improvement in mean logMAR VA. However, eight (40%) subjects improved by two or more ETDRS lines and nine eyes (45%) reached a final VA of 6/18 or better. Metamorphopsia decreased significantly (p = 0.019) and there was significant improvement in VFQ-25 mean scores for the general vision (p = 0.03), distance activities (p = 0.05), and composite score (p = 0.03). Baseline binocular VA was significantly correlated with baseline VFQ-25 composite score (r = 0.631, p = 0.004). CONCLUSIONS: ERM surgery appears to improve patients' subjective perception of visual function as indicated by higher composite scores in VFQ-25 and improved metamorphopsia in the absence of significant improvement in mean logMAR VA.
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Membrana Epirretinal/cirugía , Calidad de Vida , Trastornos de la Visión/cirugía , Vitrectomía , Adulto , Anciano , Anciano de 80 o más Años , Catarata , Distribución de Chi-Cuadrado , Sensibilidad de Contraste , Progresión de la Enfermedad , Femenino , Estado de Salud , Humanos , Masculino , Persona de Mediana Edad , Periodo Posoperatorio , Estudios Prospectivos , Resultado del Tratamiento , Trastornos de la Visión/fisiopatología , Trastornos de la Visión/psicología , Agudeza VisualRESUMEN
UNLABELLED: Langerhans cell histiocytose is a rare condition in childhood. It presents in different ways ranging from a single bony disease to a multisystemic disease involving vital organs. CASE REPORT: We report a case of single bone involvement revealed by torticollis in an eight-year-old boy. The diagnosis was evocated on radiological findings and confirmed by histologic aspects. After a period of 2,5 years, this child is in total spontaneous remission. CONCLUSION: Torticollis must be explored and watched. Eosinophilic granuloma can be a rare aetiology in children. The outcome is often favorable.