ABSTRACT
Purpose: The purpose of this study was to assess the effect of long-lasting botulinum A toxin injections on ocular surface parameters and to further investigate the relationship between these parameters and the duration of the treatment. Methods: In this retrospective study, patients with unilateral hemifacial spasm who were receiving botulinum A toxin injections for at least 1 year were analyzed. Healthy contralateral eyes acted as controls. The ocular surface examination included Ocular Surface Disease Index questionnaire, Schirmer test type I, tear film break-up time (TFBUT), tear osmolarity, corneal sensitivity, and corneal fluorescein staining. Results: Twenty-six patients (6 males and 20 females; mean age 76.4 ± 8.9 years) were included in the study. The mean duration of the treatment was 7.2 ± 5.4 years, and the mean frequency of injections was of one every 3.3 ± 0.4 months. TFBUT, Schirmer test, and corneal sensitivity were significantly lower in the eye homolateral to hemifacial spasm compared with the contralateral one (5.9 ± 3.2 vs 7.5 ± 4.2 s, P = 0.001; 6.2 ± 3.4 vs 9.2 ± 6.6 mm, P = 0.031; 50.8 ± 3.7 mm vs 52.3 ± 2.9 mm, P = 0.048, respectively). One month after the last injection, TFBUT further decreased from 5.9 ± 3.2 to 2.3 ± 1.2 s (P = 0.028). A significant positive correlation was found between the duration of treatment and tear osmolarity (? = 0.542, P = 0.025). Conclusion: Patients with hemifacial spasm under long-lasting treatment with serial botulinum A toxin injections showed a reduction in tear film production and stability, as well as corneal sensitivity in the treated eye compared with the contralateral one. Tear film stability further decreased 1 month after the last injection.
ABSTRACT
El Penfigoide Bulloso (PB), es una dermatosis ampollar, caracterizada por afectar a pacientes de edad avanzada (promedio 70 años), aun que han sido descriptos casos en pacientes jóvenes y niños. Dicha entidad cursa con lesiones ampollares grandes, localizadas en tronco y miembros. Se han descripto también lesiones prodrómicas tales como placas urticaria nas pruriginosas. La afectación mucosa se reporta entre el 10 y el 40% de los casos. Los principales diagnósticos diferenciales histopatológicos son: la erupción bullosa por drogas, por picaduras de insectos, el herpes gestacional,y la dermatitis herpetiforme por IgA, entre otras. El diagnóstico correcto permite instalar el tratamiento adecuado y así lograr reducir la tasa de mortalidad que en pacientes de edad avanzada oscila entre el 20 y el 40% situación relacionada con la edad, las comorbilidades y los tratamientos inadecuados. OBJETIVO Destacar la importancia de la correlación clínico patológica y la aplicación de técnicas de inmunofluorescencia, en todas las patologías ampollares, para lograr un diagnóstico correcto y un tratamiento adecuado en beneficio del paciente.
Bullous pemphigoid (BP) is a dermatosis blistering, characterized by affect elderly patients Advanced (average 70 years), although they have been described cases in young patients and children. This entity presents with large bullous lesions located trunk and limbs. They have also described prodromal lesions such as urticarial plaquesitch y. The mucosal involvement is reported in the 10 to 40% of cases. The main diagnoses histopathologic differentials are: bullous eruption by drugs, insect bites, herpes gestational, and dermatitis herpetiformis IgA, among others. Heinstall the correct diagnosis allows appropriate treatment and thus achieve reduced the mortality rate in elderly patients between 20 and 40% situation related to age, comorbidities and inadequate treatments. OBJECTIVE Highlighting the importance of the correlation clinico pathological and application techniques immunofluorescence all pathologies bullous, for proper diagnosis and treatment appropriate for the benefit of the patient.
Subject(s)
Humans , Female , Aged, 80 and over , Fluorescent Antibody Technique, Indirect , Pemphigoid, Bullous , Pemphigoid, Bullous/microbiologyABSTRACT
Introducción: El tacto rectal es un (TR) es un examen con baja sensibilidad para determinar la presencia de un cáncer prostático (CP). El objetivo de este trabajo es comparar el pronóstico y las características clínico-patológicas de los pacientes con y sin enfermedad palpable en pacientes con CP localizado, sometidos a prostatectomía radical. Materiales y Métodos: Se incluyeron 489 pacientes con CP localizado sometidos a PR entre enero de1999 y agosto de 2003. Los pacientes debían tener un seguimiento mínimo de 36 meses. La información se obtuvo de manera prospectiva. La recidiva bioquímica y la sobrevida fue certificada a través de registros clínicos, entrevista telefónica, certificados de defunción y medición seriada de antígenos prostático específico (APE). Se define recidiva como un APE ≥ 0,4 ng/ml Resultados: Los pacientes con estadio cT2, presentaron mayor edad, APE pre operatorio, porcentaje de muestras comprometidas en la biopsia transrectal, volumen tumoral y porcentaje de tumor en la pieza quirúrgica. No hay diferencias entre los pacientes cT1 y cT2 para el porcentaje de márgenes positivos y Score de Gleason. Se observó recidiva bioquímica en 27 por ciento y 45 por ciento de los pacientes cT1 y cT2 respectivamente. La sobrevida libre de enfermedad a los 4,5 años fue 70 por ciento para los cT1 y 57 por ciento para los cT2. Conclusiones: A pesar del tamizaje con APE y TR y del diagnóstico precoz de CP, nuestros pacientes tienen peores características que las series internacionales, por lo que el pronóstico sería afectado negativamente.
Introduction: Digital rectal examination (DRE) have low sensitivity to determine the presence of a prostate cancer (PC).The aim of this study is to compare the prognosis and clinicopathologic characteristics of patients with and without palpable disease in patients with localized PC who underwent radical prostatectomy. Materials and Methods: We included 489 patients with localized PC who underwent RP between January 1999 and August 2003. Patients should have a minimum follow-up of 36 months. The information was obtained prospectively. Biochemical recurrence and survival was ascertained through clinical records, telephone interviews, health goberment information and serial measurements of prostate-specific antigen (PSA). Relapse is defined as a PSA ≥ 0.4 ng / mlResults: Patients with stage CT2 were older and mayor pre-operative PSA, percentage of samples involved in the transrectal biopsy, tumor volume and percentage of tumor in the surgical specimen. There is no difference between CT1 and CT2 patients for the percentage of positive margins and Gleason score. Biochemical relapse was observed in 27 percent and 45 percent of patients CT1 and CT2, respectively. The disease free survival of 4.5 years was 70 percent to 57 percent for CT1 and the CT2.Conclusions: Despite the screening with PSA and DRE and early diagnosis of CP, our patients have the worst characteristics unlike international series, so the prognosis is adversely affected.