RESUMO
UNLABELLED: The purpose of this paper is to present the experience of the hospital using the Ponseti method in patients with congenital adduct clubfoot. MATERIAL AND METHODS: The study was conducted between January 2007 and December 2009. Children of both sexes were included; the Dimeglio classification was applied before surgery and their course was later assessed with the Simons scale when they resumed gait. Patients with postural clubfoot (Dimeglio I) and those with neuromuscular disease (Dimeglio IV) were excluded. Casts were placed as of 15 days of age using the Ponseti technique and then percutaneous tenotomy of the calcaneous tendon was performed in the operating room. RESULTS: Twenty patients (9 girls, 11 boys) and 28 feet were included in the study; they were Dimeglio II (8 children) and III (12 children). Mean age at the time of surgery was 2 months, and mean age at the time of gait assessment was 2 years. Upon applying the Simons scale, 25 feet (89.3%) had satisfactory results and 3 feet (10.7%) unsatisfactory results. Two of the latter underwent percutaneous tenotomy again and in one case the cast was applied again; they evolved properly. CONCLUSIONS: We found in our series that the Ponseti technique is appropriate as definitive treatment for Dimeglio II and III congenital adduct clubfoot.
Assuntos
Pé Torto Equinovaro/terapia , Moldes Cirúrgicos , Estudos Transversais , Feminino , Hospitais Gerais , Humanos , Lactente , Masculino , Procedimentos Ortopédicos , Estudos ProspectivosRESUMO
PURPOSE: To report the intra-and postoperative complications and visual acuity outcomes in pars plana vitrectomy (PPV), phacoemulsification and intraocular lens (IOL) implantation in patients with cataract and proliferative diabetic retinopathy (PDR). A comparison of the combined versus two-step surgical approach is given. METHOD: Retrospective uncontrolled interventional clinical trial. Forty-eight eyes of 48 consecutive patients with PDR were included. Twenty-eight (58.3%) eyes with combined surgery and 20 (41.7%) eyes with sequential surgery were analyzed. RESULTS: Postoperative follow-up time was between 6 and 63 months (mean: 18 months). 1) Combined surgery: Preoperative best-corrected visual acuity (BCVA) ranged from 20/200 to hand motions, and postoperative BCVA ranged from 20/30 to hand motions. BCVA improved in 17 eyes (60.7%), while in 7 (25%) eyes there was no change (> or =2 ETDRS lines) in VA, and in 4 (14.3%) eyes BCVA decreased. Postoperative complications included vitreous hemorrhage (VH) in 10 (35.7%) eyes, and fibrinous exudation in 9 (32.1%) eyes. 2) Two-step surgery: Preoperative BCVA ranged from 10/200 to light perception, and from 20/40 to light perception in the postoperative period. Best-corrected visual acuity improved in 15 (75%) eyes, remained the same in 4 (20%) eyes, and decreased in 1 (5%) eye. Postoperative complications included fibrinous exudation in 6 (30%) eyes, and VH in 3 (15%) eyes. CONCLUSION: Combined PPV, phacoemulsification and IOL implantation as well as the two-step procedure are safe and effective for the management of cataract in PDR. Sequential surgery could be advantageous to BCVA outcomes by minimizing postoperative VH, which is significantly more frequent after combined surgery.
Assuntos
Catarata/complicações , Retinopatia Diabética/cirurgia , Implante de Lente Intraocular/métodos , Facoemulsificação/métodos , Vitrectomia/métodos , Vitreorretinopatia Proliferativa/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Retinopatia Diabética/complicações , Exsudatos e Transudatos , Feminino , Fibrina , Seguimentos , Humanos , Complicações Intraoperatórias/etiologia , Complicações Intraoperatórias/cirurgia , Isquemia/complicações , Macula Lutea/irrigação sanguínea , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/etiologia , Descolamento Retiniano/etiologia , Descolamento Retiniano/cirurgia , Estudos Retrospectivos , Fatores de Tempo , Acuidade Visual , Vitreorretinopatia Proliferativa/complicações , Hemorragia Vítrea/etiologiaRESUMO
AIMS: To study the effects of intravitreal bevacizumab (Avastin) on retinal neovascularization (RN) in patients with proliferative diabetic retinopathy (PDR). METHODS: Retrospective study of patients with RN due to PDR who were treated with at least one intravitreal injection of 1.25 or 2.5 mg of bevacizumab. Patients underwent ETDRS best-corrected visual acuity (BCVA) testing, ophthalmoscopic examination, optical coherence tomography (OCT), and fluorescein angiography (FA) at baseline and follow-up visits. RESULTS: Forty-four eyes of 33 patients with PDR and a mean age of 57.2-years (range: 23-82 years) participated in the study. Thirty-three eyes (75%) had previous panretinal photocoagulation (PRP). Twenty-seven eyes (61.4%) showed total regression of RN on fundus examination with absence of fluorescein leakage, 15 eyes (34.1%) demonstrated partial regression of RN on fundus examination and FA. Follow-up had a mean of 28.4 weeks (range from 24 to 40 weeks). BCVA and OCT demonstrated improvement (P<0.0001). Three eyes without previous PRP ('naive' eyes) and with vitreous haemorrhage have avoided vitreo-retinal surgery. One eye (2.2%) had PDR progression to tractional retinal detachment requiring vitrectomy, and one eye (2.2%) had vitreous haemorrhage with increased intraocular pressure (ghost cell glaucoma). No systemic adverse events were observed. CONCLUSIONS: Intravitreal bevacizumab resulted in marked regression of RN in patients with PDR and previous PRP, and rapid resolution of vitreous haemorrhage in three naive eyes. Six-months results of intravitreal bevacizumab at doses of 1.25 or 2.5 mg in patients with PDR do not reveal any safety concerns.
Assuntos
Inibidores da Angiogênese/administração & dosagem , Anticorpos Monoclonais/administração & dosagem , Retinopatia Diabética/tratamento farmacológico , Neovascularização Retiniana/tratamento farmacológico , Adulto , Idoso , Idoso de 80 Anos ou mais , Anticorpos Monoclonais Humanizados , Bevacizumab , Feminino , Angiofluoresceinografia , Humanos , Injeções Intralesionais , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do Tratamento , Adulto JovemRESUMO
PURPOSE: The objective of this paper is to describe the optical coherence tomography (OCT) characteristics of patients with full-thickness traumatic macular hole (TMH) and to correlate them with biomicroscopy findings. METHODS: Twelve eyes of ten consecutive patients with full-thickness TMH participated in this observational retrospective multicentre study. Patients underwent biomicroscopic fundus examination, colour fundus photography, and OCT. RESULTS: Traumatic macular hole was documented with OCT in five women and five men. Mean (range) time between trauma and macular hole (MH) diagnosis was 8.1 (1-24) months. The shape of TMHs was round in 11 (91.7%) eyes. The posterior vitreous was completely detached in six (50%) eyes, and with an operculum in one (8.3%) eye. The common findings seen on OCT were: (1) full-thickness loss of retinal tissue through the hole with sharp edges, perpendicular to the retinal pigment epithelium in five (41.7%) eyes; (2) TMH with an operculum totally detached from the hole's edge in two (16.7%) eyes; (3) presence of epiretinal membrane around of the hole in three (25%) eyes; and (4) presence of abnormalities of the surrounding retina in all (100%) eyes. The OCT characteristics correlated well with biomicroscopic findings, and these characteristics may be predictive for final visual acuity (VA) in TMHs. Only one of the TMHs closed spontaneously in our series. CONCLUSION: Optical coherence tomography complements biomicroscopy in the evaluation of full-thickness TMHs.
Assuntos
Ferimentos Oculares Penetrantes/diagnóstico , Perfurações Retinianas/diagnóstico , Descolamento do Vítreo/diagnóstico , Adolescente , Adulto , Criança , Membrana Epirretiniana/cirurgia , Ferimentos Oculares Penetrantes/cirurgia , Feminino , Fundo de Olho , Humanos , Macula Lutea/cirurgia , Masculino , Microscopia Acústica , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Perfurações Retinianas/cirurgia , Estudos Retrospectivos , Tomografia de Coerência Óptica/métodos , Acuidade Visual/fisiologia , Descolamento do Vítreo/cirurgia , Adulto JovemRESUMO
AIMS: The aim of this study was to report the development or progression of tractional retinal detachment (TRD) after the injection of intravitreal bevacizumab (Avastin) used as an adjuvant to vitrectomy for the management of severe proliferative diabetic retinopathy (PDR). METHODS: The clinical charts of patients who experienced the development or progression of TRD after an intravitreal injection of 1.25 mg bevacizumab before vitrectomy for the management of PDR were reviewed. RESULTS: Eleven eyes (patients) out of 211 intravitreal injections (5.2%) that developed or had progression of TRD were identified. All eyes had PDR refractory to panretinal photocoagulation (PRP). Nine patients had type 1 diabetes mellitus (DM), and two patients had type 2 DM. Patients had a mean age of 39.5 years (range 22-62 years). In the current study, all patients used insulin administration and had poor glycaemic control (mean HbA(1c) 10.6%). Time from injection to TRD was a mean of 13 days (range 3-31 days). Mean best correct visual acuity (BCVA) at TRD development or progression was logarithm of the minimal angle of resolution (LogMAR) 2.2 (range 1.0-2.6) (mean Snellen equivalent hand motions; range 20/200 to light perception), a statistically significant worsening compared with baseline BCVA (p<0.0001). Eight eyes underwent vitrectomy and three patients refused or were unable to undergo surgery. The final mean BCVA after surgery was LogMAR 0.9 (range 0.2-2.0) (mean Snellen equivalent 20/160; range 20/32 to counting fingers), a statistically significant improvement compared with TRD BCVA (p = 0.002). CONCLUSIONS: TRD may occur or progress shortly following administration of intravitreal bevacizumab in patients with severe PDR.
Assuntos
Inibidores da Angiogênese/efeitos adversos , Anticorpos Monoclonais/efeitos adversos , Retinopatia Diabética/tratamento farmacológico , Descolamento Retiniano/induzido quimicamente , Adulto , Inibidores da Angiogênese/uso terapêutico , Anticorpos Monoclonais/uso terapêutico , Anticorpos Monoclonais Humanizados , Bevacizumab , Quimioterapia Adjuvante/efeitos adversos , Diabetes Mellitus Tipo 1/complicações , Diabetes Mellitus Tipo 2/complicações , Retinopatia Diabética/cirurgia , Progressão da Doença , Feminino , Humanos , Injeções , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fator A de Crescimento do Endotélio Vascular/antagonistas & inibidores , Vitrectomia , Corpo VítreoRESUMO
In the past few decades, a worldwide increase in the incidence of fungal infections has been observed and the resistance of some species of fungus to different fungicidals used in medical practice has also risen. This has led to the search for new antimycotics, particularly those obtained from natural sources such as plants, insects, and land and marine microorganisms. In these natural sources, a series of molecules with antifungal activity against different species of fungus of great clinical importance for humans has been found, and these substances have become an alternative for the development and formulation of new antifungals with fewer side effects, a greater spectrum of action and lower cost than those in current use. In this article, we review the main sources of molecules with antimycotic activity obtained from natural sources.
Assuntos
Antifúngicos , Produtos Biológicos/uso terapêutico , Animais , Humanos , PlantasRESUMO
El granuloma piogénico es una lesión benigna, reactiva y multifactorial, que resulta de injurias repetitivas, microtraumatismo e irritación local sobre piel o membranas mucosas. Cuando aparece en la cavidad tiene predilección por la encía vestibular, pero es importante que el odontólogo esté en conocimiento y se familiarice con el hecho de que puede localizarse en otras zonas anatómicas, es por esto que hacemos referencia en el presente artículo de dos casos de localización inusual, conjuntamente con una revisión de la literatura
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Granuloma Piogênico/cirurgia , Mucosa Bucal , Língua , Distribuição por Idade , Biópsia , Diagnóstico Diferencial , Granuloma Piogênico/epidemiologia , Distribuição por Sexo , VenezuelaRESUMO
The isolation of telomeres from the phytopathogenic fungus Ustilago maydis is described. The telomeric repeat from the plant Arabidopsis thaliana, TTTAGGG, cross-hybridizes to Bal31-sensitive fragments of U. maydis DNA and detects many or all of the U. maydis chromosomes separated by pulsed-field gel electrophoresis (PFGE). This telomeric repeat was used to screen a library enriched for chromosome ends. Three clones were isolated which contained the tandemly repeated sequence TTAGGG. This sequence is identical to some known telomere repeats found in humans and other vertebrates as well as in some protozoa and moulds. In addition, the three telomeric clones had an almost identical 376 bp segment of middle-repeated telomere-associated sequences adjacent to the telomeric repeat. This segment hybridized to many or all U. maydis chromosomes separated by PFGE and showed a hybridization pattern in genomic digestions similar to that of the telomeric repeat. These results indicate that in U. maydis the same segment of telomere-associated sequences is located adjacent to the telomeric repeat in many or all chromosomes, which suggests that it may have a common role in chromosome function.
Assuntos
Sequências Repetitivas de Ácido Nucleico , Ustilago/genética , Arabidopsis/genética , Sequência de Bases , Clonagem Molecular , Sequência Conservada , DNA Fúngico/genética , Dados de Sequência Molecular , Homologia de Sequência do Ácido Nucleico , TelômeroRESUMO
Se presentan tres pacientes con lesiones hipocrómicas, en uno de ellos francamente vitiligoides, debidas al uso de jabones que contienen fenoles y a repelente con derivado toluénico. El estudio histopatológico mostró disminución de la cantidad de melanina, con discreta reacción liquenoide epidérmica, que sugeriría un mecanismo inmunológico en la patogenia de estos cuadros. Las lesiones estaban localizadas en sitios expuestos y en un caso pudieron ser reproducidas por el fotopatch test, por lo que se presumen la existencia de un factor lumínico coadyuvante
Assuntos
Adulto , Idoso , Humanos , Masculino , Feminino , Fenóis/efeitos adversos , Sabões/efeitos adversos , Tolueno/efeitos adversos , Vitiligo/induzido quimicamente , QuímicaRESUMO
Se presentan tres pacientes con lesiones hipocrómicas, en uno de ellos francamente vitiligoides, debidas al uso de jabones que contienen fenoles y a repelente con derivado toluénico. El estudio histopatológico mostró disminución de la cantidad de melanina, con discreta reacción liquenoide epidérmica, que sugeriría un mecanismo inmunológico en la patogenia de estos cuadros. Las lesiones estaban localizadas en sitios expuestos y en un caso pudieron ser reproducidas por el fotopatch test, por lo que se presumen la existencia de un factor lumínico coadyuvante (AU)