Ocular Manifestations in Patients with Fanconi Anemia: A Single-Center Experience Including 106 Patients.

OBJECTIVES: To describe the prevalence of acquired ocular manifestations in patients with Fanconi anemia (FA) and to describe and correlate the congenital ocular malformations with the genetic subtypes of the disease. STUDY DESIGN: This is a cross-sectional observational study of 106 consecutive patients with confirmed diagnosis of FA who were followed at the Hematopoietic Stem Cell Transplantation (HSCT) Service at the Federal University of Paraná, Curitiba, Parana, Brazil. Participants underwent a complete ophthalmologic evaluation and 84 patients underwent ocular ultrasound examination. This study was conducted between November 2014 and August 2017. RESULTS: The patients ranged in age from 6 months to 43 years of age. Microphthalmia was the most common congenital ocular abnormality (95.2%). A decrease in anthropometric measurements was observed, including palpebral fissure length (78/103 patients [76.5%]), microcornea (48/103 patients [46.6%]), and ptosis (31/103 patients [30.1%]). We identified a new ophthalmic condition in 15 patients with FA, that is, epiretinal tissue on the optic disc. The genetic subtype was identified in 78 patients (79.6%), the FA-A subtype was most prevalent (50%). The most common acquired ocular manifestation (non-graft-versus-host disease [GVHD] related) in patients who did not undergo HSCT (n = 44) was limbal neovascularization (13.6%), whereas in patients who underwent HSCT (n = 62), the GVHD-related manifestation was ocular GVHD (51.6%). The most frequent symptom of ocular GVHD was keratoconjunctivitis sicca (29%). CONCLUSIONS: Several ocular manifestations were identified in patients with FA.

[Anterior ischemic optic neuropathy and polyarteritis nodosa: case report]. / Neuropatia óptica isquêmica anterior e poliarterite nodosa: relato de caso.

We describe a patient with polyarteritis nodosa being treated with cytostatics and corticosteroids who developed an anterior ischemic optic neuropathy, a rare manifestation of this pathology.

Neuropatia óptica isquêmica anterior e poliarterite nodosa: relato de caso / Anterior ischemic optic neuropathy and polyarteritis nodosa: case report

Descreve-se uma paciente com diagnóstico de poliarterite nodosa, em tratamento com citostáticos e corticosteróides que desenvolveu neuropatia óptica isquêmica anterior, uma manifestacão considerada bastante rara para esta doenca.

[Laparoscopic treatment of peri-appendicitis caused by intrauterine contraceptive device]. / Tratamento laparoscópico de periapendicite causada por dispositivo intra-uterino.

BACKGROUND: Intrauterine device may perforate the uterus and cause several complications. AIM: To report a case of laparoscopic treatment of peri-appendicitis caused by intrauterine device. PATIENT AND METHOD: A young female presented with pain in the right lower abdomen of 4 days of duration. On the physical examination, she had localized abdominal pain in the right lower abdomen with discrete guarding and pain on percussion and rebound tenderness. Ultrasonography showed an intrauterine device outside of the uterus, in the right lower of the abdomen. RESULTS: At laparoscopy, an inflammatory mass that consisted of the intrauterine device blocked by the mesoappendix and the appendix was observed. Appendectomy and removal of the intrauterine device were performed. CONCLUSION: Laparoscopy allows adequate treatment of peri-appendicitis caused by intrauterine device, inclusive with complete evaluation of the entire pelvic region to rule out associated complications

Tratamento laparoscópico de periapendicite causada por dispositivo intra-uterino / Laparoscopic treatment of peri-appendicitis caused by intrauterine contraceptive device

RACIONAL: Dispositivo intra-uterino pode perfurar o útero e causar várias complicações. OBJETIVO: Descrever um caso de tratamento laparoscópico de periapendicite causada por dispositivo intra-uterino. MATERIAL E MÉTODOS: Jovem do sexo feminino apresentou dor em fossa ilíaca direita de 4 dias de duraçäo. No exame físico, apresentava dor abdominal localizada em fossa ilíaca direita, com discreta renitência de parede e dor à percussäo e descompressäo brusca na regiäo. A ultra-sonografia evidenciou dispositivo intra-uterino fora do útero, na fossa ilíaca direita. RESULTADOS: A laparoscopia, observou-se massa inflamatória que consistia do dispositivo intra-uterino totalmente bloqueado pelo mesoapêndice e apêndice. Apendicectomia e retirada do dispositivo foram realizadas. CONCLUSÄO: A laparoscopia permite o tratamento adequado da periapendicite causada por dispositivo intra-uterino, inclusive com avaliaçäo adequada de toda a regiäo pélvica para excluir lesöes associadas.

Transconjunctival lower lid blepharoplasty / Blefaroplastia inferior transconjuntival

Although tranconjunctival lower lid blepharoplasty was described many years long ago, it has only been in recent years, with the advent of laser, that its indication has become almost imperative. Thanks to this revival, tranconjunctival blepharoplasty has been indicated in many situations. Authors have been using it more recently in most cases where resectioning or repositioning of the eyelid pads is necessary. Also, whenindicated, scalped or laser skin resection follows immediately. In this manner, since there are no lesions to nerve and muscle structures, mainly pre-tarsal structures, most of the complications of lower lid blepharoplasty can be avoided.