394 research outputs found
Bacteriological conversion in twenty urinary tuberculosis patients treated with ofloxacin, rifampin and isoniazid: a 10-year follow-up study
Twenty patients withuri nary tuberculosis were treated withofloxac in (200 mg/day, 6 months), rifampin (600 mg/day, 3 months) and isoniazid (300 mg/day, 3 months) between 1989 and 1990. All patients were new cases, diagnosed by observation and/or isolation of Mycobacterium tuberculosis in one of the three morning urine samples. Bacteriological culture conversion (negativization) was assessed as a clinical guide of efficacy, comparing it, as the only parameter, against a control group (150 patients) withurina ry tuberculosis who received conventional therapy. Bacteriological follow-up studies were performed in bothgroups monthly for 6 months, then again 6 months later and then every year for 10 years after completion of treatment. In the 20 patients, the initial culture was positive with over 100 colonies per culture (>50%); the smear was positive in 45% of the patients (most were 2+). All strains were susceptible to rifampin, isoniazid and ofloxacin. Two patients discontinued treatment. Beginning withth e first monthof treatment, the bacteriological conversion was 100%, 89.5% and 100% in the remaining controls. In the control group, which received conventional treatment, the conversion was: 90%, 87%, 93% and 100% in the remaining controls. Treatment withofloxacin resulted in a bacteriological conversion similar to that following conventional treatment (p>0.05, Fisher’s exact test). After 10 years of patient follow-up, we conclude that ofloxacin, in combination withrifampin and isoniazid (bothfor 3 months only is effective against M. tuberculosis, providing satisfactory bacteriological and clinical efficacy
Manifestaciones corneales en las enfermedades sistémicas
Systemic diseases affecting the cornea have a wide
range of manifestations. The detailed study of all
pathologies that cause corneal alteration is
unapproachable, so we have centered our interest in
the most prevalent or characteristic of them. In this
paper we have divided these pathologies in sections to
facilitate their study. Pulmonar and conective tissue
(like colagen, rheumatologic and idiopathic inflamatory
diseases), dermatologic, cardiovascular, hematologic,
digestive and hepatopancreatic diseases with corneal
alteration are described. Endocrine and metabolic
diseases, malnutrition and carential states are also
studied, as well as some otorhinolaryngologic and
genetic diseases that affect the cornea. Finally, a brie
Cirrus high-definition optical coherence tomography compared with Stratus optical coherence tomography in glaucoma diagnosis
To compare the retinal nerve fiber layer (RNFL) evaluation using Cirrus
optical coherence tomography (OCT) and Stratus OCT in glaucoma diagnosis.
METHODS: One hundred thirty normal and 86 patients with glaucoma were included in
this prospective study. The signal strengths of the OCTs were evaluated. The
sensitivities and specificities of global RNFL average thickness were compared in
the four quadrants and in each clock hour sector. Receiver operating
characteristic (ROC) curves, areas under the ROC (AUC), and the likelihood ratio
(LR) were plotted for RNFL thickness. Agreement between the OCTs was calculated
by using the Bland-Altman method and kappa (kappa) coefficient. RESULTS:
Twenty-three percent of all cases examined with Stratus OCT and 1.9% examined
with Cirrus OCT had a signal strength below 6 (P = 0.01). In cases with signal
strengths > or =6, the mean signal strength was higher with Cirrus OCT than with
Stratus OCT (P = 0.01). The RNFL measurements by Cirrus were thicker than those
of Stratus OCT (P < 0.05). The AUCs were 0.829 for Stratus and 0.837 for Cirrus
OCT (P = 0.706) for global RNFL average. LRs were similar in both OCTs in global
RNFL classification but varied in quadrants. The widths of the limits of
agreement varied between 42.16 and 97.79 microm. There was almost perfect
agreement (kappa = 0.82) in the average RNFL classification. CONCLUSIONS: Cirrus
OCT has better scan quality than Stratus OCT, especially in glaucomatous eyes. In
cases with good-quality scans, the sensitivity and specificity, and AUCs were
similar. The best agreement was in the global average RNFL classification. The
widths of limits of agreements exceed the limits of resolution of the OCTs
OCT angiography: a technique for the assessment of retinal and optic nerve diseases in the pediatric population
Optical coherence tomography angiography (OCT-A) is a novel, rapidly evolving,
non-invasive imaging technique that allows images of the retinal vasculature to be obtained in a few
seconds. Blood vessels of different retinal vascular plexuses and the foveal avascular zone (FAZ) can
be examined without the administration of any contrast or dye. Due to these characteristics, OCT-A
could be an excellent complementary test to study retinal vascularization in children. Until now,
most of the studies with OCT-A have been conducted in adults and only a few have been carried
out in children. In this review, we describe the principles and advantages of OCT-A over traditional
imaging methods and provide a summary of the OCT-A findings in retinopathy of prematurity and
other retinal and optic disc pathologies in children. In view of the promising results from studies, the
advantages of a relatively rapid and non-invasive method to assess the retinal vasculature makes
OCT-A a tool of which applications in the field of pediatric ophthalmology will be expanded in the
near future for patient diagnosis and follow-up in every day clinical practice
Osteomielitis y tumor de Ewing: aspectos clínicos y radiográficos comunes
La osteomielitis aguda y el tumor de Ewing, dos entidades de naturaleza
bien distinta, pueden mostrar semejanzas clínicas y radiográficas. Presentamos un caso
de tumor de Ewing clásico y dos de osteomielitis que plantearon sendas dudas diagnósticas.
Concluimos insistiendo en la importancia de un diagnóstico diferencial definitivo
precoz mediante biopsia y cultivo en estas circunstancias.Acute osteomyelitis and Ewing's sarcoma are diseases of quite different
natur e which may show similar clinical and radiographic characteristics. The author s
present a case of classic Ewing's sarcoma ant two case s of osteomyelitis that suposed
diagnosti c doubts in each case . They conclude emphasizing on the importanc e of an
early, definitive differential diagnosis in thes e circunstance s by means of a biopsy and
bacteriologic culture
Optical Coherence Tomography Features of Active and Inactive Retinal Neovascularization in Proliferative Diabetic Retinopathy
PURPOSE: To describe spectral domain-optical coherence tomography features of retinal neovascularization in proliferative diabetic retinopathy and thus to identify novel signs of new vessel activity.
METHODS: Retrospective, cross-sectional study. Data were collected over a 9-month period. Spectral domain optical coherence tomography scans were performed over areas of new vessel complexes (NVC) in both the disk and elsewhere, and were qualitatively graded by two masked observers. New vessel complexes activity was determined using clinical and angiographic criteria and correlated with spectral domain optical coherence tomography features.
RESULTS: Forty-three eyes of 30 patients with proliferative diabetic retinopathy were included. Sixty-one NVC lesions (neovascularization of the disk—37.7%, neovascularization elsewhere—62.3%) were captured by spectral domain-optical coherence tomography and analyzed. Among them, 63.9% were classified as active and 36.1% as quiescent. Five distinctive features were identified as significantly different between active and quiescent NVC: the presence of vitreous hyperreflective dots in active NVC (P = 0.002) and the presence of epiretinal membrane (P = 0.04), inner retinal tissue contracture (P = 0.03), vitreous invasion (P = 0.02), and protrusion towards vitreous (P = 0.002) in quiescent NVC.
CONCLUSION: In this exploratory study, the presence of vitreous hyperreflective dots, epiretinal membrane, inner retinal tissue contracture, vitreous invasion, and vitreous protrusion were identified as distinct signs of disease activity. Such parameters may be useful as a noninvasive imaging modality in eyes undergoing treatment for proliferative diabetic retinopathy
Acrysof® toric intraocular lens implantation in cataract surgery
Aim: To assess the medium term outcomes of Acrysof® toric intraocular lens implantation
in 54 patients (54 eyes).
Methods: Uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), preoperative
astigmatism, residual postoperative astigmatism, and global average and model-specific
intraocular lens (IOL) rotation grade were analyzed.
Results: At 2-months of follow-up,the mean UCVA was 0.83 (SD: 0.14) Snellen scale, with
73.9% of the patients ≥0.8, and 32.6% with 1.0. Mean BCVA achieved was 0.94 (SD: 0.10).
Mean preoperatory astigmatism was –2.25 diopters (D) (SD: 0.78), and mean postoperative
astigmatism was -0.32 D (SD: 0.56), with significant differences between both groups
(p<0.001). Model-specific mean residual astigmatism was –0.1 D for T3, –0.27 D for T4 and
–0.43 D for T5, without significant differences between the three models (p=0.483). Mean
IOL-axis rotation grade was 3.87±3.25 degrees, with 91.6% of implanted lens within 10° of
predicted axis.
Discussion: T3, T4 and T5 Acrysof® Toric intraocular lenses can correct preoperative
astigmatism with a high success rate in terms of UCVA, and residual postoperative
astigmatism, with minimum IOL-rotation grade at 2 months follow-up period
Paracentral acute middle maculopathy after uneventful ocular surgery with local anaesthetic blocks
OBJECTIVE: To describe the role of local anaesthetic blocks as a potential cause of paracentral acute middle maculopathy (PAMM) after uneventful ocular surgery. METHODS: Retrospective, observational, international, multicentre case series. Nine cases of PAMM with associated visual loss following uneventful ocular surgery with local anaesthetic blocks were observed in a 9-year period (2011-2020). Demographic, ocular and systemic data, anaesthetic data and surgical details were collected. Visual acuity (VA), fundus photography, fluorescein angiography, optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) images were reviewed. RESULTS: All nine cases were associated with decreased VA at 24 h postoperative check (ranging from hand movement to 20/200). A hyperreflective band within the middle retinal layers was observed in the structural OCT in the acute phase, evolving to thinning and atrophy of the inner retinal layers in sequential follow-up scans performed. Fluorescein angiography showed delayed perfusion in early arterial phase with normal perfusion in late venous phases. OCTA showed decreased perfusion in the deep capillary plexus. Visual recovery was variable between cases during follow-up (ranging from count fingers to 20/20). CONCLUSIONS: A combination of a vasoconstrictive effect of the anaesthetic agent, an intraocular pressure spike and a mechanical effect of the volume of anaesthetic injected may result in decreased retinal artery perfusion and be evidenced as PAMM in OCT scans. PAMM may present as a potential complication of local anaesthetic blocks in cases of unexpected visual loss after uneventful ocular surgery
Intravitreal bevacizumab associated with grid laser photocoagulation in macular edema secondary to branch retinal vein occlusion
To evaluate intravitreal bevacizumab (IVB) combined with grid laser
photocoagulation in macular edema (ME) secondary to branch retinal vein occlusion
(BRVO). METHODS: Eight eyes (8 patients) with ME associated with BRVO with at
least 3 months of evolution since symptom onset were included. All subjects
underwent measurement of best-corrected visual acuity (BCVA) and imaging with
spectral domain optical coherence tomography (SD-OCT) at baseline and 1, 3, 6,
and 12 months. Intravitreal bevacizumab was administered at baseline and macular
grid laser photocoagulation 1 month later. During follow-up, additional IVB was
administered based on physician discretion if persistent or recurrent
intraretinal fluid (cysts) was observed on SD-OCT. The mean BCVA and SD-OCT
central subfield thickness (CST) values were determined at each time point.
Fisher exact test was performed to assess differences between baseline and
post-treatment BCVA and SD-OCT measurements. RESULTS: The mean baseline BCVA was
0.28+/-0.14 (mean+/-SD), and the mean CST was 479+/-137 microm. The mean BCVAs at
1, 3, 6, and 12 months were 0.47+/-0.18 (p=0.031), 0.56+/-0.50 (p=0.031),
0.65+/-0.60 (p=0.008), and 0.66+/-0.65 (p=0.016), respectively. The mean CST
values at 1, 3, 6, and 12 months were 295+/-60 microm (p=0.008), 333+/-114 microm
(p=0.070), 339+/-80 microm (p=0.008), and 335+/-109 microm (p=0.008). A mean 2.13
injections were administered; the second injection was administered a mean of
2.71 months after baseline. CONCLUSIONS: Combined treatment with IVB and macular
grid photocoagulation provided good results and may be considered as an
alternative therapy for ME in BRVO. Further studies are needed to assess these
preliminary results
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