ABSTRACT
OBJECTIVE: To understand the long-term prognosis of patients with occupational medicamentosa-like dermatitis induced by trichloroethylene( OMDT) after recovery. METHODS: A total of 185 patients with OMDT were surveyed through landline and correspondence after recovery. Based on the individual's wishes,19 patients( follow-up examination group)were followed up and arranged for health examination in hospital. RESULTS: Seventy-one cases of OMDT was successfully follow-up. The success rate was 38. 4%( 71/185). Among the 71 cases who were successfully followed up,64. 8%( 46/71)cases complained of physical discomfort. The main complain included skin itching,allergy,upper respiratory tract infection or frequent fever,xerophthalmus,osteonecrosis of femoral head. The 19 cases in the follow-up examination group had different degrees of skin itching,dryness and mild melanosis. The abnormal rates of schirmer I test were 42. 1%( 8/19)and 52. 6%( 10/19) in the left and right eye,respectively. The abnormal rate of tear break-up time in both left and right eyes was 84. 2%( 16/19). The highest positive rate of patch test was chloral hydrate( 100. 0%). There was no abnormality in body temperature,superficial lymph nodes,blood routine,urine routine,liver function and autoimmunity antibody. There was no new rash. CONCLUSION: Different degree of long-term prognosis can occur in OMDT recovery patients. Xerophthalmus and osteonecrosis of femoral head are the major sequelae. Chloral hydrate,which is the main metabolite of trichloroethylene,may be the causative culprit compound for OMDT.
ABSTRACT
Abstract?AIM: To investigate the risk factors and prognosis of posterior capsular rupture in phacoemulsification cataract surgery through analyzing the cataract patients in our hospital.?METHODS:Totally 1825 patients (1912 eyes) treated in our hospital were selected from November 2012 to November 2015. The patients with posterior capsular rupture were as observation group.Control group was randomly selected with a 1: 4 ratio in patients without posterior capsular rupture.All the patient's age, gender, type of cataract, ocular disease history, other medical history, surgical history, preoperative intraocular pressure, the eyes affected, the health situation, visual acuity at 1d before and after surgery and other factors were recorded and analyzed for risk factors and prognosis.?RESULTS: Statistical results showed gender, type of cataract, preoperative intraocular pressure, history of tobacco and alcohol, eyes affected and other factors did not impact on the rupture rate ( P>0.05 ); and type of nucleus, preoperative visual acuity, some eye diseases were the risk factors for posterior capsule rupture ( P<0.05).Postoperative visual acuity of the two groups was all improved, but visual acuity of patients with posterior capsule rupture significantly decreased.?CONCLUSION: With eye disease history ( a history of vitreous hemorrhage, retinal detachment before surgery and preoperative visual acuity <20/200) are more likely to result in intraoperative posterior capsular rupture.Nuclear hardness over grade Ⅳ is also an important risk factor. Before one surgery, it is needed to learn more about the medical history of cataract patients, to conduct a reasonable comprehensive assessment for risk factors, to decrease the risk in the surgery, which are to increase the success rate and to improve the prognosis.
ABSTRACT
A prevalência de meningite tuberculosa (MTB) nos países em desenvolvimento mantém-se alta, e a doença continua a ter uma elevada taxa de morbimortalidade entre crianças. Neste trabalho, relatamos nossa experiência com casos de MTB, mostrando os achados clínicos, laboratoriais e radiológicos, assim como o tratamento e a seqüência após alta hospitalar. Foram revisados os registros de 29 pacientes com MTB ocorridos no período de 1o de janeiro de 1984 a dezembro de 2001. Houve predomínio do sexo masculino e da cor branca. A média de idade do início dos sintomas foi de 43 meses, variando de 2 meses a 12 anos. O esquema terapêutico mais freqüente foi rifampicina, isoniazida e pirazinamida. Seis pacientes evoluíram para óbito. Todos os pacientes realizaram exames culturais de líquido cefalorraquidiano para M tuberculosis, sendo positivos em 5 (17%). TB pulmonar foi detectada em 8 casos. O tempo médio de internação foi de 41 dias. Quinze de 21 pacientes pesquisados fizeram vacina BCG. Dezenove pacientes (66%) tinham história de contato íntimo com familiar com TB. Lesão cerebral motora foi a seqüela mais freqüente. Glicorraquia menor de 40 mg/dl foi relacionado como fator de risco para lesão cerebral motora, assim como idade menor de 4 anos de idade. Nossos achados mostram que a ocorrência de sinais meníngeos pode funcionar como um fator de proteção para a ocorrência de lesão cerebral motora assim como de proteinorraquia maior que 300 mg/dl (AU)
The prevalence of tuberculous meningitis (TBM) in the developing countries remains high, and this disease still has a elevated rate of morbimortality among children. In this study,we report our cases of TBM, describing clinical, laboratorial and radiological findings, as well the treatment and outpatient follow up. Medical charts from 29 patients interned with TBM from January 1984 to December 2001 were reviewed. There were predominance of male sex and white race. The mean age at the start of clinical manifestations was 43 months old, ranging from 2 months old to 12 years old. The more frequent tuberculostatic association was rifampin, isoniazid and pyrazinamide. Six patients died. Cerebrospinal fluid was collected from all patients, and the cultures for M tuberculosis were positive in five cases (17%). Pulmonary disease was detected in 8 cases. The mean time of hospitalization was 41 days. Fifteen from 21 patients has done BCG vaccine. Nineteen patients (66%) had contact with contaminated household. Motor cerebral lesion was the more frequent sequelae. Glucorrachia less than 40 mg/dl was related as a risk factor to motor cerebral lesion, as weel as age less than 4 years old. Our findings also point to the occurrence of meningeal signs and protein from cerebrospinal fluid above 300 mg/dl as protective factors for arising of motor cerebral lesion (AU)