2 research outputs found
Supplementary Material for: Prolonged Button Battery Exposure Leading to Severe Ocular Injury Without Heavy Metal Poisoning
Introduction
Prolonged exposure to a complete button battery can cause severe tissue necrosis in the eye and permanent impairment of visual function. The main mechanism of injury is the current generated by the hydrolysis of tissue fluid at the negative electrode and the production of hydroxide ions.
Case Presentation
A 3-year-old girl,went to the local hospital because of swelling and pain in her right eye of 12 hours’ duration. The local doctor performed an orbital CT(Computer Tomography)scan and found a foreign body between the right eyelid and the eyeball. The foreign body was removed immediately under general anesthesia. And it was found that the foreign body was a button battery, but it prolonged 39 hours from the onset of the child’s symptoms. The child underwent a second operation in our hospital and receiving amniotic membrane transplantation combined with conjunctival flap coverage. Topical corticosteroid and antibiotic eye ointment was continue for 3 months after surgery. Local Pigmentation was seen, no symblepharon, but the cornea was still opaque and the visual acuity was only FC(Finger Count). In this particular case, heavy metal testing conducted on the child's blood fortunately revealed that the levels were within the normal range.
Conclusion
Early detection and urgent removal of button battery is crucial in order to minimise exposure time. We should also be concerned about heavy metals in the blood.Children should be kept away from button batteries as much as possible to avoid such injury
Supplementary Material for: Outcomes in Melanoma Patients Treated with BRAF/MEK-Directed Therapy or Immune Checkpoint Inhibition Stratified by Clinical Trial versus Standard of Care
<p><b><i>Objectives:</i></b> Since 2011, metastatic melanoma treatment
has evolved with commercial approval of BRAF- and MEK-targeted therapy
and CTLA-4- and PD-1-blocking antibodies (immune checkpoint inhibitors,
ICI). While novel therapies have demonstrated improved prognosis in
clinical trials, few studies have examined the evolution of prognosis
and toxicity of these drugs among an unselected population. We assess
whether survival and toxicity reported in trials, which typically
exclude most patients with brain metastases and poor performance status,
are recapitulated within a commercial access population. <b><i>Methods:</i></b>
182 patients diagnosed with stage IV melanoma from July 2006 to
December 2013 and treated with BRAF- and/or MEK-targeted therapy or ICI
were prospectively studied. Outcomes and clinicopathologic differences
between trial and commercial cohorts were assessed. <b><i>Results:</i></b>
Patients receiving commercial therapy (vs. on trial) had poorer
prognostic features (i.e., brain metastases) and lower median overall
survival (mOS) when assessed across all treatments (9.2 vs. 17.5 months,
<i>p</i> = 0.0027). While toxicity within trial and commercial cohorts
did not differ, patients who experienced toxicity had increased mOS (<i>p</i> < 0.001), irrespective of stratification by trial status or therapy. <b><i>Conclusion</i></b>:
Metastatic melanoma patients receiving commercial treatment may
represent a different clinical population with poor prognostic features
compared to trial patients. Toxicity may prognosticate treatment
benefit.</p