Manifestaciones cutáneas en pacientes hemodializados crónicos: Estudio prospectivo sore 100 casos / Cutaneous manifestations in chronic hemodialysis patients: Study with 100 cases

Las manifestaciones cutáneas, son comunes y diversas en los pacientes con insuficiencia renal crónica (IRC), sobre todo, en aquellos en hemodiálisis (HD). Estas pueden ser anteriores al inicio de la diálisis o podrían ser precipitadas por ella. Materiales y Métodos: estudio observacional, descriptivo, de serie de casos, prospectivo a través del examen de piel realizado por dermatólogos, a 100 pacientes con IRC en HD del Servicio de Nefrología del Hospital Provincial del Centenario de Rosario, Argentina durante el período comprendido entre el 1 de Junio de 2013 hasta el 1 de Junio de 2014. Resultados: en este estudio se incluyeron 100 pacientes con IRC en HD, de los cuales 91 presentaron manifestaciones cutáneas. Discusión: la frecuencia de patologías cutáneas en pacientes con IRC en HD, varía del 50 al 100% y generalmente, se observan más de una manifestación cutánea. Esto coincide con lo hallado en nuestro trabajo, donde de los 100 pacientes: 91 presentaban lesiones y de éstos, la mayoría presentaba 2 o más. Respecto de la edad, el rango es amplio y en nuestro trabajo se observó un predominio en el sexo masculino, al igual que en otros estudios.

Skin manifestations are common and diverse in patients with chronic renal failure (CRF), especially those on hemodialysis (HD). These may be prior to initiation of dialysis or could be precipitated by it. Materials and Methods: observational, descriptive, case series, prospective through the skin examination by dermatologists of 100 patients with CKD on HD in the Nephrology Service of Hospital Provincial del Centenario of Rosario, Argentina during the period June 1, 2013 to June 1, 2014. Results: in this study of 100 patients with CRF in HD, of which 91 had cutaneous manifestations were included. Discussion: the frequency of skin diseases in patients with CRF in HD, varies from 50 to 100% and it is usually seen more than one cutaneous manifestation. This coincides with the findings in our study where from 100 patients, 91 had injuries and of these the majority had 2 or more. Regarding age, the range is wide and our study found a predominance in males, as in other studies.

Nanophthalmos and hemiretinal vein occlusion: a case report

Many risk factors have been linked to retinal vein occlusions [RVOs] whether central or branch retinal vein occlusion. Ocular risk factors include glaucoma and hypermetropia. Controversy exists to whether short axial length is a risk factor for retinal vein occlusions. We report an extreme case that supports the latter hypothesis. A 33-year-old male presented with decreased visual acuity in the left eye. He turned out to have nanophthalmos with hemiretinal vein occlusion and macular edema with unremarkable systemic work up for retinal vein occlusion except for a glycated hemoglobin [HbA1c] level of 7%. To our knowledge this is the first case report of hemiretinal vein occlusion in the setting of nanophthalmos and suggests that short axial length may be a risk factor for retinal vein occlusion

case of cat-scratch disease with unusual ophthalmic manifestations

We report a case of cat-scratch disease with unusual posterior segment manifestations. A 12-year-old healthy male presented with three weeks history of decreased visual acuity in the right eye. A significant history of cat exposure and elevated Bartonella titers were present. A large white-gray vascularized mass extending off the optic disk, an early stellate maculopathy, a plaque of choroiditis, an inferior serous retinal detachment involving the macula were present in the right eye. Sector papillitis and a focal area of chorioretinitis along the superotemporal arcade with associated retinal artery to vein anastomosis were present in the left eye. Bilateral optic nerve head involvement including peripapillary angiomatosis, retinal-retinal anastomosis and plaque choroiditis as ocular complications of cat-scratch disease have not been previously described to our knowledge and make this case noteworthy

Comparison of optical coherence tomography findings in a patient with central retinal artery occlusion in one eye and end-stage glaucoma in the fellow eye

This case describes a patient with chronic central retinal artery occlusion in one eye and end-stage traumatic glaucoma in the fellow eye. Optical coherence tomography [OCT] of the macula of the chronic phase of central retinal artery occlusion of the right eye indicated loss of the normal foveal depression, extensive inner retinal atrophy, and marked retinal thinning. In contrast, scans of the left eye with end-stage glaucoma demonstrated an intact foveal depression and limited retinal thinning. The pattern of macular OCT findings in this patient illustrates distinguishing features between chronic central retinal artery occlusion and chronic optic neuropathy due to end-stage glaucoma

A Bayesian approach to estimate the prevalence of low height-for-age from the prevalence of low weight-for-age

Victora et al. (1998) propuseram o uso de estimativas de prevalência de baixo peso para idade para a estimaçäo de déficit de altura para idade em crianças brasieiras, em virtude da necessidade de simplificar métodos usados em programas de saúde comunitária. Tenta aprofundar o referido estudo ao propor uma aordagem Bayesiana com base no método de Simulaçäo Estocástica via Cadeia de Markov (SEvCM), para lidar com questöes de imprecisäo ligadas à modelagem de estimaçäo do déficit de estatura. Para evitar valores inválidos de prevalência estimados pelo modelo linear sugerido originalmente, propöem-se duas alternativas: um truncamento dos valores que extrapolem os limites plausíveis de prevalência ou uma transformaçäo logito das prevalências. A abordagem Bayesiana é ilustrada com um exemplo de um estudo comunitário. Imprecisöes oriundas da complexidade do desenho desse estudo também säo contornadas com a abordagem Bayesiana, ao se introduzir uma estrutura hierárquica ou multinível. Já que o déficit de crescimento foi efetivamente observado no exemplo, também serve como instância de validaçäo para o procedimento proposto por Victora et al.