Retrospective case series of high-density silicone oil (Oxane HD) in severe proliferative vitreorretinal retinal detachment patients.

BACKGROUND: Describe complications and clinical outcomes of heavy silicone oil (HSO) Oxane HD® use as an alternative to overcome the challenges of performing vitrectomy to treat tractional and rhegmatogenous retinal detachments with proliferative vitreoretinopathy (PVR). METHODS: A retrospective, observational study was performed on patients from one center from August 2014 to Aug 2023. It was included patients who underwent surgery using HSO Oxane HD® to treat rhegmatogenous retinal detachment with PVR or mixed tractional and rhegmatogenous diabetic retinal detachment. Severely ill patients who could not attend to follow up were excluded. The primary outcome was successful retinal attachment at first postoperative month. A descriptive analysis was performed. RESULTS: Among the 31 patients, 29 (93.5%) underwent surgeries due to rhegmatogenous retinal detachment and two (6.5%) for diabetic retinal detachment. The primary anatomic success was achieved in 27 (87.1%) patients. At the final visit, 17 (56.6%) had vision better than 20/400 (range, 20/30 to light perception). The vision was stable or improved in 22 (76.8%) patients at the end of follow-up. Nineteen (61.3%) patients required hypotensive eye drops after HSO use and twelve (38.7%) still required hypotensive eye drops at the final follow-up; three (9.7%) patients required additional glaucoma surgeries. CONCLUSIONS: HSO is safe and useful for complex retinal detachments cases specially with inferior tears and PVR. Ocular hypertension is frequent and usually clinically controlled with hypotensive eyedrops. Close postoperatively follow-up is advised due to the ocular complications, particularly elevated intraocular pressure and emulsification.

Thoracic sympathectomy at the level of the fourth and fifth ribs for the treatment of axillary hyperhidrosis.

OBJECTIVE: To describe the clinical results and the degree of satisfaction of patients submitted to thoracic sympathectomy at the level of the fourth and fifth ribs (R4-R5) for the treatment of axillary hyperhidrosis. METHODS: We included 118 patients diagnosed with axillary hyperhidrosis and having undergone axillary sympathectomy at the R4-R5 level between March of 2003 and December of 2007 at the Paraná Federal University Hospital de Clínicas, located in the city of Curitiba, Brazil. All procedures were carried out by the same surgeon. Data regarding the resolution of axillary hyperhidrosis and the degree of patient satisfaction with the surgical outcome, as well as compensatory hyperhidrosis in the early and late postoperative periods (after 7 days and after 12 months, respectively), were collected. RESULTS: Of the 118 patients evaluated, 99 (83.9%) and 81 (68.6%) showed complete resolution of the symptoms in the early and late postoperative periods, respectively. Compensatory hyperhidrosis occurred in 49 patients (41.5%) in the early postoperative period and in 77 (65.2%) in the late postoperative period. Of those 77, 55 (71.4%) categorized the compensatory hyperhidrosis as mild. In the early postoperative period, 110 patients (93.2%) were satisfied with the surgical results, and 104 (88.1%) remained so in the late postoperative period. CONCLUSIONS: Sympathectomy at the R4-R5 level is efficient in the resolution of primary axillary hyperhidrosis. The degree of patient satisfaction with the long-term surgical results is high. Mild compensatory hyperhidrosis is the main side effect associated with this technique.

[Impact of antiretroviral therapy on occurrences of macrocytosis in patients with HIV/AIDS in Maringá, State of Paraná]. / Impacto do tratamento antirretroviral na ocorrência de macrocitose em pacientes com HIV/AIDS do município de Maringá, Estado do Paraná

INTRODUCTION: AIDS is a disease caused by HIV that compromises the organism's immune system. The advent of highly active antiretroviral therapy (HAART) has promoted substantial improvement in the prognosis for this disease and in HIV/AIDS patients' quality of life. During prolonged treatment, certain hematological disorders are observed, such as anemia and macrocytosis, as well as deficiencies of micronutrient such as vitamin B12 and folic acid. The objective of this study was to correlate the presence of macrocytosis and anemia with HAART use or vitamin B12 and folic acid deficiencies. METHODS: 110 HIV-positive patients were included, in three groups: HAART use with zidovudine (AZT) (group 1), HAART use without AZT (group 2) and no HAART (group 3). RESULTS: None of the patients in any of the three groups presented statistically significant differences relating to hemoglobin level (p = 0.584) or folic acid level (p = 0.956). Group 1 (G1) had a higher mean corpuscular volume (MCV) than G3 (p < 0.05), and group 2 (G2) had a higher volume than group 3 (G3) (p < 0.001). Vitamin B12 levels in G1 and G3 were smaller than those in G2 (p = 0.008). CONCLUSIONS: It was concluded that patients undergoing HAART treatment presented macrocytosis, even though this could not be correlated with the type of HAART or with vitamin B12 deficiency. However, folic acid deficiency was unrelated to either HAART or macrocytosis.

Simpatectomia torácica ao nível de 4ª e 5ª costelas para o tratamento de hiper-hidrose axilar / Thoracic sympathectomy at the level of the fourth and fifth ribs for the treatment of axillary hyperhidrosis

OBJETIVO: Descrever os resultados clínicos e o grau de satisfação de pacientes submetidos à simpatectomia torácica ao nível de 4ª e 5ª costelas (R4-R5) para o tratamento da hiper-hidrose axilar. MÉTODOS: Foram incluídos 118 pacientes com diagnóstico de hiper-hidrose axilar e submetidos à simpatectomia torácica ao nível de R4-R5, realizada por um único cirurgião, no Hospital de Clínicas da Universidade Federal do Paraná, Curitiba (PR), entre março de 2003 e dezembro de 2007. Dados relativos à resolução da sudorese axilar, ao grau de satisfação com o resultado da cirurgia e ao efeito compensatório no pós-operatório precoce (7 dias) e tardio (1 ano) foram coletados. RESULTADOS: Dos 118 pacientes do estudo, 99 (83,9 por cento) e 81 (68,6 por cento) apresentaram resolução total dos sintomas no pós-operatório precoce e tardio, respectivamente. Houve efeito compensatório em 49 pacientes (41,5 por cento) no pós-operatório precoce e em 77 (65,2 por cento) no pós-operatório tardio. Desses 77, 55 (71,4 por cento) consideraram esses efeitos como leves. No pós-operatório precoce, 110 pacientes (93,2 por cento) estavam satisfeitos com os resultados da cirurgia, enquanto 104 pacientes (88,1 por cento) mantinham-se satisfeitos no pós-operatório tardio. CONCLUSÕES: A simpatectomia ao nível R4-R5 é eficaz na resolução da hiper-hidrose axilar primária. O grau de satisfação dos pacientes com os resultados em longo prazo é alto. O efeito compensatório leve é o principal efeito colateral relacionada a essa técnica.

OBJECTIVE: To describe the clinical results and the degree of satisfaction of patients submitted to thoracic sympathectomy at the level of the fourth and fifth ribs (R4-R5) for the treatment of axillary hyperhidrosis. METHODS: We included 118 patients diagnosed with axillary hyperhidrosis and having undergone axillary sympathectomy at the R4-R5 level between March of 2003 and December of 2007 at the Paraná Federal University Hospital de Clínicas, located in the city of Curitiba, Brazil. All procedures were carried out by the same surgeon. Data regarding the resolution of axillary hyperhidrosis and the degree of patient satisfaction with the surgical outcome, as well as compensatory hyperhidrosis in the early and late postoperative periods (after 7 days and after 12 months, respectively), were collected. RESULTS: Of the 118 patients evaluated, 99 (83.9 percent) and 81 (68.6 percent) showed complete resolution of the symptoms in the early and late postoperative periods, respectively. Compensatory hyperhidrosis occurred in 49 patients (41.5 percent) in the early postoperative period and in 77 (65.2 percent) in the late postoperative period. Of those 77, 55 (71.4 percent) categorized the compensatory hyperhidrosis as mild. In the early postoperative period, 110 patients (93.2 percent) were satisfied with the surgical results, and 104 (88.1 percent) remained so in the late postoperative period. CONCLUSIONS: Sympathectomy at the R4-R5 level is efficient in the resolution of primary axillary hyperhidrosis. The degree of patient satisfaction with the long-term surgical results is high. Mild compensatory hyperhidrosis is the main side effect associated with this technique.

Impacto do tratamento antirretroviral na ocorrência de macrocitose em pacientes com HIV/AIDS do município de Maringá, Estado do Paraná / Impact of antiretroviral therapy on occurrences of macrocytosis in patients with HIV/AIDS in Maringá, State of Paraná

INTRODUÇÃO: AIDS é uma doença causada pelo HIV que compromete o sistema imune do organismo. O advento da terapia antirretroviral (TARV) altamente eficaz promoveu melhora substancial do prognóstico da doença e da qualidade de vida dos pacientes com HIV/AIDS. Durante seu tratamento prolongado, notam-se algumas alterações hematológicas, dentre elas, anemia e macrocitose, bem como carências de micronutrientes, tais como, de vitamina B12 e ácido fólico. O objetivo do presente trabalho é relacionar a macrocitose e anemia ao uso de TARV, ou à deficiência de vitamina B12 ou de ácido fólico. MÉTODOS: Foram avaliados 110 pacientes HIV positivos, comparando-se aqueles em uso de TARV com zidovudina (AZT) (grupo 1), TARV sem AZT (grupo 2) ou sem uso de TARV (grupo 3). RESULTADOS: Os pacientes dos três grupos não apresentaram diferenças estatísticas significativas quanto aos níveis de hemoglobina (p = 0,584) e de ácido fólico (p = 0,956). Os pacientes do grupo 1 (G1) apresentaram volume corpuscular médio (VCM) aumentado quando comparado ao grupo 3 (G3) (p < 0,05), bem como do grupo 2 (G2) em relação ao G3 (p < 0,001). As dosagens de vitamina B12 do G1 e G3 foram menores do que as encontradas pelo G2 (p = 0,008). CONCLUSÕES: Conclui-se que os indivíduos em uso de TARV apresentaram macrocitose, embora não pudesse ser relacionada ao tipo de TARV ou a deficiência de vitamina B12. Entretanto, a deficiência de ácido fólico não esteve relacionada ao uso de TARV e nem à macrocitose.

INTRODUCTION: AIDS is a disease caused by HIV that compromises the organism's immune system. The advent of highly active antiretroviral therapy (HAART) has promoted substantial improvement in the prognosis for this disease and in HIV/AIDS patients' quality of life. During prolonged treatment, certain hematological disorders are observed, such as anemia and macrocytosis, as well as deficiencies of micronutrient such as vitamin B12 and folic acid. The objective of this study was to correlate the presence of macrocytosis and anemia with HAART use or vitamin B12 and folic acid deficiencies. METHODS: 110 HIV-positive patients were included, in three groups: HAART use with zidovudine (AZT) (group 1), HAART use without AZT (group 2) and no HAART (group 3). RESULTS: None of the patients in any of the three groups presented statistically significant differences relating to hemoglobin level (p = 0.584) or folic acid level (p = 0.956). Group 1 (G1) had a higher mean corpuscular volume (MCV) than G3 (p < 0.05), and group 2 (G2) had a higher volume than group 3 (G3) (p < 0.001). Vitamin B12 levels in G1 and G3 were smaller than those in G2 (p = 0.008). CONCLUSIONS: It was concluded that patients undergoing HAART treatment presented macrocytosis, even though this could not be correlated with the type of HAART or with vitamin B12 deficiency. However, folic acid deficiency was unrelated to either HAART or macrocytosis.