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Turk J Ophthalmol ; 49(5): 294-296, 2019 Oct 24.
Artigo em Inglês | MEDLINE | ID: mdl-31650813


Endogenous endophthalmitis is a serious sight-threatening ocular emergency that usually occurs in patients with serious underlying risk factors. In this report, we describe a case of endogenous Candida endophthalmitis following trans-urethral lithotripsy in an immunocompetent woman. In our case, the retinal lesion regressed completely and vision was restored. We discuss diagnostic procedures and management strategies in this article.

Antifúngicos/uso terapêutico , Candida albicans/isolamento & purificação , Candidíase/terapia , Endoftalmite/terapia , Infecções Oculares Fúngicas/terapia , Litotripsia/efeitos adversos , Vitrectomia/métodos , Adulto , Candida albicans/genética , Candidíase/etiologia , Candidíase/microbiologia , DNA Fúngico/análise , Endoftalmite/etiologia , Endoftalmite/microbiologia , Infecções Oculares Fúngicas/etiologia , Infecções Oculares Fúngicas/microbiologia , Feminino , Humanos , Tomografia por Emissão de Pósitrons , Cálculos Ureterais/terapia , Acuidade Visual
J Curr Ophthalmol ; 31(1): 95-97, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30899854


Purpose: To report severe immunologic and toxic reaction due to corneal wasp sting that may cause catastrophic sight-threatening outcomes. Methods: A 45-year-old man referred to the emergency room with corneal wasp sting of Vespa Orientalis. The authors review previous Medline literature about this topic. Results: In our case, the response to frequent topical corticosteroid was dramatic, and at the seventh day after injury, all inflammatory responses in the anterior segment of the eye had been resolved. Conclusion: Corneal wasp injury with Vespa Orientalis can cause severe inflammation of the cornea and the anterior segment. Topical corticosteroids are the mainstay of treatment.

J Ophthalmic Inflamm Infect ; 9(1): 5, 2019 Feb 20.
Artigo em Inglês | MEDLINE | ID: mdl-30788635


PURPOSE: To report a case of endogenous Candida endophthalmitis that may cause catastrophic sight-threatening outcomes, after extracorporeal shock wave lithotripsy (ESWL) in a healthy woman. CASE PRESENTATION: A 32-year-old woman presented to the ophthalmology clinic with the symptom of blurred vision and floater in her right eye. She underwent ESWL for renal stone 1 week prior to her presentation. Fundus examination showed an elevated white lesion in para-fovea with fluffy border. Smear of diagnostic vitreous sampling showed pseudo-hypha and budding yeast. Systemic and immunologic and infectious workups were unremarkable. In our case, response to intravitreal and intravenous injection of amphotericin-B and oral fluconazole was dramatic. Six weeks after starting the treatment, infiltrative lesion completely disappeared. The authors review previous MEDLINE literature about this topic. CONCLUSION: Endogenous Candida endophthalmitis following renal stone lithotripsy is a serious and rare intraocular infection that may happen in healthy individuals without any risk factors.

Interv Med Appl Sci ; 9(2): 56-60, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28932498


BACKGROUND: Dissection of aorta is a rare, but fatal complication of aortic cannulation in cardiac surgery can be caused by the sudden rise in blood pressure and hemodynamic variations. METHODS: In this study, 90 patients aged 18 years or older undergoing cardiac surgery were divided into two equal groups. Under similar conditions, trial group received 1.5 mg/kg of lidocaine for 90 s before cannulation and control group received normal saline. Hemodynamic parameters of patients including systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), heart rate (HR), and central venous pressure before cannulation and 1, 3, and 5 min after cannulation were recorded in a form. Consumed nitroglycerin (TNG) rate was also measured and recorded. RESULTS: In the lidocaine group, compared with the placebo group, mean SBP, DBP, and MAP significantly reduced after cannulation (P < 0.05). During the follow-up period, mean HR (P = 0.649) and TNG usage (P = 0.527) were similar in two groups. CONCLUSION: Intravenous lidocaine, 1.5 mg/kg, 90 s before cannulation leads to a reduction in SBP, DBP, and MAP, up to 5 min after cannulation, so it can decrease risk of aortic dissection.

Middle East J Anaesthesiol ; 20(2): 265-9, 2009 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-19583076


PURPOSE: The disadvantages of intravenous regional anesthesia (IVRA) include slow onset, poor muscle relaxation, tourniquet pain, and rapid onset of pain after tourniquet deflation. In this randomized, double-blind study, we evaluated the effect of nitroglycerin (NTG) in quality improvement when added to lidocaine in IVRA. METHODS: Forty-six patients (20-50 yrs), were randomly allocated in two equal groups. Under identical condition, the control group received a total dose of 3 mg/kg of lidocaine 1% diluted with saline, and the study group received an additional 200 microg NTG. Vital signs and tourniquet pain, based on visual analog scale (VAS) score were measured and recorded before and 5, 10, 15, 20, and 30 min after anesthetic solution administration. The onset times of sensory and motor block were measured and recorded in all patients. After the tourniquet deflation, at 30 min and 2, 4, 6, 12 and 24 h, VAS score, time to first analgesic requirement, total analgesic consumption in the first 24 h after operation, and side effects were noted. RESULTS: The sensory and motor block onset time were shortened in study group (2.61 vs. 5.09 and 4.22 vs. 7.04 min, respectively) (p < 0.05). The recovery time of sensory and motor block and onset of tourniquet pain were also prolonged (7.26 vs. 3.43, 9.70 vs. 3.74 and 25 vs. 16.65 min., respectively) (p < 0.05). Analgesia time after tourniquet deflation was prolonged and tourniquet pain intensity was lowered in study group (p < 0.05). Intraoperative fentanyl and meperedine requirement during first postoperative day and pain intensity at 4, 6, 12 and 24 hr postoperatively were lower in the study group (p < 0.05). There were no significant side effects. CONCLUSION: The NTG adding to lidocaine in intravenous regional anesthesia shortens onset times of sensory and motor block and decreases the tourniquet and postoperative pain, without any side effect.

Anestésicos Locais/uso terapêutico , Lidocaína/uso terapêutico , Nitroglicerina/uso terapêutico , Torniquetes , Adulto , Anestesia por Condução/métodos , Anestésicos Locais/efeitos adversos , Método Duplo-Cego , Quimioterapia Combinada , Feminino , Traumatismos do Antebraço/cirurgia , Fixação de Fratura/métodos , Humanos , Lidocaína/efeitos adversos , Masculino , Pessoa de Meia-Idade , Nitroglicerina/efeitos adversos , Dor/tratamento farmacológico , Dor/etiologia , Medição da Dor , Estudos Prospectivos , Fatores de Tempo , Torniquetes/efeitos adversos , Vasodilatadores/efeitos adversos , Vasodilatadores/uso terapêutico , Adulto Jovem