[Night blindness and xerophthalmia after surgery for morbid obesity]. / Ceguera nocturna y xeroftalmía tras cirugía de obesidad mórbida.

CASE REPORT: We describe ocular findings due to a vitamin A deficiency in a 50-year-old man. The patient had undergone intestinal bypass surgery two years before. After therapy with oral vitamin A the symptoms improved. DISCUSSION: The incidence of morbid obesity is increasing throughout much of the developed world, with intestinal bypass surgery the treatment of choice for most people with the condition. This type of surgery can lead to a vitamin A deficiency, with remarkable ophthalmological consequences, which without correct treatment may ultimately cause blindness. For this reason, the pathology, even though rare at present, must considered seriously.

Ceguera nocturna y xeroftalmía tras cirugía de obesidad mórbida / Night blindness and xerophthalmia after surgery for morbid obesity

Caso clínico: Se describen los hallazgos oculares debidos a un déficit de vitamina A en un varón de 50 años. Fue sometido a una cirugía de bypass intestinal dos años antes. Después de tratamiento con vitamina A oral, los síntomas mejoraron. Discusión: La incidencia de obesidad mórbida sigue aumentando alarmantemente en todo el mundo, siendo actualmente el tratamiento mas adoptado en la mayoría de los pacientes la cirugía de bypass intestinal. Este tipo de cirugía puede provocar un déficit de vitamina A, con importantes consecuencias oftalmológicas, que podrían incluso llegar a la ceguera sin un correcto tratamiento. Por consiguiente, se debería considerar seriamente esta patología hasta ahora poco frecuente en países desarrollados

Case report: We describe ocular findings due to a vitamin A deficiency in a 50-year-old man. The patient had undergone intestinal bypass surgery two years before. After therapy with oral vitamin A the symptoms improved. Discussion: The incidence of morbid obesity is increasing throughout much of the developed world, with intestinal bypass surgery the treatment of choice for most people with the condition. This type of surgery can lead to a vitamin A deficiency, with remarkable ophthalmological consequences, which without correct treatment may ultimately cause blindness. For this reason, the pathology, even though rare at present, must considered seriously

Prophylaxis of early bacterial infections after autologous peripheral blood stem cell transplantation (PBSCT): a matched-pair study comparing oral fluoroquinolones and intravenous piperacillin-tazobactam.

The safety and efficacy of early bacterial prophylaxis with piperacillin-tazobactam were prospectively evaluated in 51 autologous peripheral blood stem cell transplantation (PBSCT) recipients. The results were compared with those obtained in 51 control patients receiving oral fluoroquinolones in a retrospective matched-pair control study. Overall, 76% of the study group and 98% of the control group developed at least one febrile episode during neutropenia (P=0.002). Time from neutropenia to the first febrile episode (FFE) was significantly longer in the study group than in the control group (P=0.04). Once a febrile episode appeared, the duration of fever was significantly longer in cases than in controls (median of 5 and 2 days respectively, P<0.001), and led to a more frequent use of empirical amphotericin B (AmB), not statistically significant (P=0.13). However, the total time of antibiotic administration was significantly greater in the control than in the study group (P=0.05). The duration of AmB treatment shows a trend toward a longer duration in the control than in study group (P=0.2). Overall, 86% of the Gram-positive bacteremia and 85% of the Gram-negative bacteria were susceptible to the tested antibiotics. Our study suggests that a subgroup of patients could benefit from prophylaxis with piperacillin-tazobactam without increasing toxicity or bacterial resistance.