Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 16.084
Filtrar
2.
Rev. cuba. pediatr ; 92(1): e991, ene.-mar. 2020. tab
Artigo em Espanhol | LILACS (Américas), CUMED | ID: biblio-1093745

RESUMO

Introducción: La epilepsia es motivo de consulta frecuente en los servicios de neuropediatría a nivel mundial, con incidencia máxima en el menor de un año, se asocia con retraso del neurodesarrollo y recurrencia de las crisis. Objetivo: Caracterizar a los lactantes con epilepsia según aspectos clínicos, electro-encefalográficos, terapéuticos y la recurrencia de las crisis epilépticas. Métodos: Estudio observacional, prospectivo y longitudinal en 50 lactantes con epilepsia ingresados en el Hospital William Soler: 2016 a 2018. Se analizaron variables demográficas, clínicas y paraclínicas, tratamiento y recurrencia a los seis meses de iniciado el tratamiento antiepiléptico. Resultados: El inicio de las crisis se presentó de 1 a 4 meses en 60 por ciento, con predominio del sexo masculino (60 por ciento). El 44 por ciento presentó retraso del neurodesarrollo global y 32 por ciento parálisis cerebral. Predominaron las crisis epilépticas generalizadas motoras espasmos epilépticos (32 por ciento); la epilepsia generalizada (60 por ciento), el síndrome epiléptico: el síndrome de West (32 por ciento) y de etiología: desconocida (48 por ciento). El trazado electroencefalográfico más frecuente fue el generalizado (26 por ciento) seguido de hisparritmia (24 por ciento) La vigabatrina y el fenobarbital fueron los antiepilépticos más utilizados al inicio del tratamiento (24 por ciento cada uno. La recurrencia fue alta (62 por ciento). Conclusiones: La epilepsia en el lactante es más frecuente en varones y de inicio precoz. El retraso del neurodesarrollo global constituyó un factor asociado a la recurrencia de las crisis epilépticas. La parálisis cerebral, los hallazgos en estudios de neuroimagen y la etiología estructural son factores clínicamente significativos para la recurrencia(AU)


Introduction: Epilepsy is a reason of frequent consultation in neuropediatrics services at the global level, with peak incidence in infants of less than one year old. This is associated with neurodevelopmental delay and seizures recurrence. Objective: To characterize infants with epilepsy according to clinical, electro-encephalographic, therapeutic aspects and the seizures recurrence. Methods: Observational, prospective and longitudinal study in 50 infants with epilepsy whom were admitted in William Soler Hospital from 2016 to 2018. There were analysed demographic, clinical and paraclinical variables, and the treatment and recurrence six months after the beginning of the antiepileptic treatment. Results: The beginning of the seizures was at 1 to 4 months in the 60 percent, with predominance of males (60 percent). 44 percent presented global neurodevelopmental delay and 32 percent cerebral palsy. Generalized motor epileptic seizures and epileptic spasms predominated (32 percent); generalized epilepsy (60 percent), epilepsy syndrome: West syndrome (32 percent); and of unknown etiology (48 percent). The most frequent electroencephalographic tracing was the generalized one (26 percent) followed by hypsarrhythmia (24 percent). Vigabatrin and phenobarbital were the most commonly antiepileptic drugs used at the beginning of treatment (24 percent) each. Recurrence was high (62 percent). Conclusions: Epilepsy in the infant is more common in males and of early-onset. The delay in the global neurodevelopment was a factor associated with the recurrence of seizures. Cerebral palsy, findings in neuroimaging studies and the structural etiology are clinically significant factors for recurrence(AU).


Assuntos
Humanos , Masculino , Feminino , Lactente , Recidiva , Epilepsia Neonatal Benigna/epidemiologia , Estudos Prospectivos , Estudos Longitudinais
3.
Rev. colomb. obstet. ginecol ; 71(1): 21-33, Jan.-Mar. 2020. tab
Artigo em Espanhol | LILACS (Américas) | ID: biblio-1115617

RESUMO

RESUMEN Objetivo: determinar la eficacia y seguridad de la monoterapia con cloroquina en gestantes colombianas con ataque agudo no complicado de malaria vivax (MGV). Materiales y métodos: estudio de cohorte prospectiva en pacientes gestantes que consultaron de manera espontánea entre 1 febrero de 2015 y 31 diciembre de 2017 a los puestos de malaria o de control prenatal en dos poblaciones de Colombia, en quienes se confirmó el diagnóstico de Plasmodium vivax mediante gota gruesa y qPCR (quantitative polymerase chain reaction). Se midieron variables sociodemográficas, falla terapéutica (FT) y eventos adversos serios a los 28 días y la frecuencia de recurrencia-recaída (RR) con seguimiento de 120 días. Se aplicó el protocolo de la OMS para evaluar la eficacia de monoterapia con cloroquina (m-CQ). Resultados: se captaron 47 gestantes; en el seguimiento de 28 días no hubo pérdidas y hubo 4,2 % (2/47) de FT. En el seguimiento de 45 mujeres entre los días 29 y 120 hubo 11 pérdidas (24,4 % = 11/45) y 13 RR con frecuencia que varió entre 29 y 53 % según el tipo de análisis. Conclusiones: la cloroquina conserva muy alta eficacia para curar el ataque agudo de malaria vivax en malaria gestacional (MG) en Colombia, y continúa siendo una buena opción para el tratamiento de la fase aguda. La frecuencia de RR es alta. Se requieren estudios que evalúen alternativas terapéuticas en la MG. Hay urgente necesidad de disponer de medicamentos o procedimientos que reduzcan ese altísimo riesgo.


ABSTRACT Objective: To determine the efficacy of chloroquine monotherapy in Colombian pregnant women with acute uncomplicated malaria vivax Materials and methods: Prospective cohort study in pregnant women who presented of their own accord between February 1, 2015 and December 31, 2017 to malaria or prenatal care centers in two Colombian towns and in whom the diagnosis of Plasmodium vivax was confirmed by means of blood spot test and and quantitative polymerase chain reaction (qPCR). Measured variables included sociodemographics, therapeutic failure (TF) and serious adverse events at 28 days and frequency of recurrence-relap (RR) over a follow-up period of 120 days. The WHO protocol was applied for the assessment of monotherapy with cloroquine (m-CQ) efficacy. Results: Overall, 47 pregnant women were identified. During the 28-day follow-up period there were no losses, and there were two cases of TP (4.2%=2/47). Of the 45 women followed between 29 and 120 days, 11 were lost (24.4%=11/45) and there were 13 cases of RR, with an RR frequency ranging between 29 and 53 % depending on the type of analysis. Conclusions: Chloroquine is still highly effective as a cure of acute malaria vivax attack in GM in Colombia, and continues to be a good option for the treatment of acute phase GM. The RR frequency is high. Studies are required that evaluate therapeutic alternatives in MG. There is a pressing need for medications and/or procedures that can help reduce this very high risk.


Assuntos
Humanos , Feminino , Gravidez , Malária , Plasmodium vivax , Recidiva , Gravidez , Cloroquina , Eficácia , Colômbia
4.
Rev. argent. coloproctología ; 31(1): 31-33, mar. 2020. ilus
Artigo em Espanhol | LILACS (Américas) | ID: biblio-1102182

RESUMO

El sinus pilonidal es una patología frecuente cuya malignización es infrecuente aunque su pronóstico puede ser fatal. El objetivo de esta publicación es presentar un caso de un paciente intervenido en múltiples ocasiones de escisiones de sinus pilonidal con degeneración maligna del mismo y evolución fatal, con el fin de recalcar la importancia del examen anatomopatológico sistemático de todas las muestras de escisión quirúrgica. (AU)


The pilonidal sinus is a frequent pathology whose malignization is uncommon although its prognosis can be fatal. The objective of this publication is to present a case of a patient intervened on multiple occasions of pilonidal sinus excisions with malignant degeneration and fatal evolution, in order to emphasize the importance of the systematic pathological examination of all surgical excision samples. (AU)


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Seio Pilonidal/cirurgia , Seio Pilonidal/patologia , Carcinoma de Células Escamosas/patologia , Segunda Neoplasia Primária/cirurgia , Seio Pilonidal/mortalidade , Radioterapia , Recidiva , Reoperação , Cisplatino/administração & dosagem , Segunda Neoplasia Primária/mortalidade , Quimioterapia Adjuvante/métodos , Antineoplásicos/administração & dosagem
6.
Neumol. pediátr. (En línea) ; 15(1): 278-281, Mar. 2020. ilus, tab
Artigo em Espanhol | LILACS (Américas) | ID: biblio-1088103

RESUMO

We present a case of organized chronic pneumonia (OCP), a rare interstitial disease, which usually affects people over 50 years of age and is very unusual in pediatrics, so we thought it was of interest to communicate it. Is a 14-year-old male in whom in the study of a febrile condition, a pneumonia of LII was detected. The images persist after 2 months of being treated and being asymptomatic. Infectious causes and rheumatic diseases were ruled out due to the history of discoid lupus. Chest CT, bronchoalveolar lavage and lung biopsy showing Masson's bodies were performed and OCP was diagnosed. He received prednisone 1 mg / kg day and Clarithromycin for 2 months with rapid improvement. Relapses with new radiological images typical of OCP twice, when treating on alternate days. It is indicated prednisone 30 mgr / day for 3 months and gradual reduction. At 18 months, being with prednisone 5 mgr day, has a relapse of rapid progression that was treated with pulses of methylprednisolone. The collagen study shows positive lupus anticoagulant and ANA and Systemic Lupus is diagnosed. The bad evolution would be explained because it was a secondary OCP. Mycophenolate associated with prednisone was indicates, which has been used in the OCP and in Lupus. This clinical case shows the importance of radiological follow-up of patients with OCP and the search for secondary OCP causes due to the poor response to corticosteroids.


Se presenta un caso de neumonía crónica organizada (NCO), enfermedad intersticial rara, que afecta habitualmente a mayores de 50 años y muy inusual en pediatría, por lo que creímos de interés comunicarlo. Se trata de un varón de 14 años en el que en el estudio de un cuadro febril se detecta una neumonía de LII cuyas imágenes persisten luego de 2 meses de haber sido tratado y estando asintomático. Se descartaron causas infecciosas y enfermedades reumatológicas por el antecedente de lupus discoide. Se realizó TC de tórax, lavado broncoalveolar y biopsia pulmonar que mostró cuerpos de Masson, con lo que se diagnosticó NCO. Recibió prednisona 1 mgr/ kg día y Claritromicina por 2 meses con una rápida mejoría. Recae con nuevas imágenes radiológicas típicas de NCO dos veces, al pasar de tratamiento diario a días alternos. Se indica 30 mgr/día por 3 meses de prednisona y reducción gradual posterior. A los 18 meses de tratamiento, estando con prednisona 5 mgr día, tiene una recaída de rápida progresión que se trató con pulsos de metilprednisolona. El estudio de colagenosis muestra anticoagulante lúpico y ANA positivos y se diagnóstica Lupus Sistémico. La mala evolución se explicaría porque se trató de una NCO secundaria, ante lo cual indicó micofenolato asociado a prednisona, que se ha usado en la NCO y en el Lupus. Este caso clínico muestra la importancia del seguimiento radiológico de los pacientes con NCO y de la búsqueda de causas secundarias de NCO ante la mala respuesta a corticoides


Assuntos
Humanos , Masculino , Adolescente , Pneumonia em Organização Criptogênica/tratamento farmacológico , Pneumonia em Organização Criptogênica/diagnóstico por imagem , Recidiva , Prednisona/uso terapêutico , Radiografia Torácica , Tomografia por Raios X , Doença Crônica , Pneumonia em Organização Criptogênica/patologia
7.
Int. j. morphol ; 38(1): 186-192, Feb. 2020. graf
Artigo em Inglês | LILACS (Américas) | ID: biblio-1056419

RESUMO

As a result of their intense physical activity, racehorses suffer high tendon stress which may result in various pathologies. One of these is tendonitis in the tendon of the superficial digital flexor muscle (TSDFM). Conventional treatment with rest, has not shown to be very effective, and regenerative medicine through the application mesenchymal stem cells appears to be a promising therapy. The objective of this work was to assess the effect of the application of autologous MSC on reduction of the scar length in recurrent TSDFM tendinitis in Holsteiner horses, using image analysis. This study included two groups of five animals each: A control group that received conventional treatment (CG) and an experimental group which was also treated with intralesional injections of MSC (EG). Scar evolution was assessed by echographic analysis, with measurements taken of the scar length over a four month period; the length at month zero, was taken as the initial value of 100 %. During the first month, the mean scar length diminished to 81.14 % (EG) and 95.85 % (CG); after the second month, lengths were 64.4 % (EG) and 92.3 % (CG); following the third month lengths were 51.92 % (EG) and 87.42 % (CG); finally at the end of the fourth month the lengths recorded were 26.7 % (EG) and 83.92 % (CG). These results show that treatment with autologous MSC helps TSDFM scar length was significantly reduced, as compared to conventional treatment.


Reducción de la cicatriz de tendinitis recidivante mediante células Madre mesenquimales autólogas derivadas de tejido adiposo de la base de la cola en equinos Holsteiner (Equus ferus caballus). En equinos deportistas, la actividad física intensa ocasiona gran estrés en los tendones, pudiendo ocasionar diversas patologías como la tendinitis del tendón del músculo flexor digital superficial (TMFDS). El tratamiento convencional con reposo es poco eficaz, siendo la medicina regenerativa a través de la aplicación de células madres mesenquimáticas (MSC) una promisoria terapia. El objetivo de este trabajo, fue evaluar el efecto de la aplicación de MSC autólogas, sobre la reducción de la longitud de la cicatriz en tendinopatías recidivantes del TMFDS en equinos Holsteiner, a través del análisis de imagen. Este estudio conto con dos grupos de cinco animales cada uno, el grupo control mantuvo el tratamiento convencional (GC) y el grupo experimental fue tratado adicionalmente con inyección interlesional de MSC (GE). El análisis ecográfico permitió evaluar la evolución de la cicatriz, a través de la medición de su longitud durante los cuatros meses, tomando la longitud del mes cero como la medición inicial del 100 %. Durante el primer mes, la longitud de la cicatriz se redujo a un 81,14 % (GE) y 95,85 % (GC), al segundo mes la longitud fue de un 64,4 % (GE) y de 92,3 % (GC), al tercer mes, la longitud fue de 51,92 (GE) y un 87,42 (GC), finalmente al cuarto mes la longitud fue de 26,7 % (GE) y del 83,92 % (GC). Estos resultados muestran que el tratamiento con MSC autólogas favorece a la disminución de la longitud de la cicatriz del TMFDS de forma significativa respecto al tratamiento convencional.


Assuntos
Animais , Cicatrização , Tecido Adiposo , Tendinopatia/terapia , Células-Tronco Mesenquimais , Recidiva , Modelos Animais de Doenças , Tendinopatia/complicações , Cavalos
8.
Arch. argent. pediatr ; 118(1): 31-37, 2020-02-00. tab, graf, ilus
Artigo em Inglês, Espanhol | LILACS (Américas), BINACIS | ID: biblio-1095338

RESUMO

Introducción. La púrpura de Schönlein-Henoch (PSH) es la vasculitis leucocitoclástica de pequeños vasos más común en la infancia. Se caracteriza por púrpura palpable y/o compromiso articular, abdominal o renal. Objetivo: Describir las características epidemiológicas, clínicas, de laboratorio y evolutivas en pacientes con PSH. Población y métodos. Estudio observacional, descriptivo, retrospectivo. Se incluyeron pacientes menores de 15 años durante el período 1/1/2008 al 31/12/2017 que cumplían con los criterios de Ankara para el diagnóstico de PSH. Resultados. Se incluyeron 339 pacientes con PSH; la distribución fue similar en ambos sexos; edad promedio de presentación: 7,02 años (± 3,02). El 78 % presentó forma típica y el 22 %, atípica, con compromiso articular previo a la aparición de la púrpura. Manifestaciones articulares: el 82 %; compromiso abdominal: el 54 %; manifestaciones renales: el 19 %. El 68 % de los pacientes que tuvieron compromiso renal lo manifestaron dentro del primer mes desde el debut. El síntoma más frecuente fue la hematuria aislada y el 22 % de los pacientes con compromiso renal presentó formas moderadas-graves de nefritis. El 15 % de los pacientes presentó recurrencia/s. Conclusión. Las manifestaciones articulares fueron más frecuentes de lo descrito en otras series y el compromiso renal fue menor. Si bien este compromiso suele manifestarse en los primeros meses de evolución, se destaca la necesidad del seguimiento de estos pacientes con controles urinarios y de tensión arterial en la evaluación pediátrica.


Introduction. Henoch-Schönlein purpura (HSP) is the most common small vessel leukocytoclastic vasculitis during childhood. It is characterized by palpable purpura and/or joint, abdominal or renal involvement. Objective. To describe the epidemiological, clinical, laboratory, and evolutionary characteristics of patients with HSP. Population and methods. Observational, descriptive, and retrospective study. Patients younger than 15 years who met the Ankara criteria for HSP diagnosis were included in the period between 1/1/2008 and 12/31/2017.Results. A total of 339 patients with HSP were included; the male/female distribution was similar; their average age at onset was 7.02 years (± 3.02). The typical form was observed in 78 % and the atypical form, in 22 %, with joint involvement prior to purpura onset. Joint manifestations: 82 %; abdominal involvement: 54 %; renal manifestations: 19 %. Among patients with renal involvement, 68 % experienced it in the first month after onset. The most common symptom was isolated hematuria, and 22 % of patients with renal involvement had moderate to severe nephritis. Recurrences were observed in 15 % of patients. Conclusion. Joint manifestations were more common than what has been described in other series, whereas renal involvement was less common. Although it usually occurs in the first months of disease onset, it is worth noting that these patients need follow-up with urinary and blood pressure controls as part of their pediatric assessment.


Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Criança , Adolescente , Púrpura de Schoenlein-Henoch/epidemiologia , Púrpura de Schoenlein-Henoch/diagnóstico , Púrpura de Schoenlein-Henoch/tratamento farmacológico , Recidiva , Dor Abdominal , Epidemiologia Descritiva , Estudos Retrospectivos , Fatores de Risco , Insuficiência Renal
9.
Blood Research ; : 27-34, 2020.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-820806

RESUMO

BACKGROUND: Although T-cell-replete hematopoietic cell transplantation (HCT) from haploidentical donors (HIDs) using anti-thymocyte globulin (ATG) has shown promising outcomes, previous studies often adopted heterogenous graft sources and conditioning.METHODS: We retrospectively compared HCT outcomes from 62 HIDs, 36 partially-matched unrelated donors (PUDs), and 55 matched unrelated donors (MUDs) in patients with acute leukemia or myelodysplastic syndrome using the same graft source of peripheral blood and a reduced intensity conditioning of busulfan, fludarabine, and ATG.RESULTS: The estimates of 3-yr disease-free survival (DFS) and overall survival (OS) rates were not significantly different among the MUD, HID, and PUD groups, at 46%, “41%, and 36%” for the DFS rate (P=0.844), and 55%, 45%, and 45% for the OS rate (P=0.802), respectively. Cumulative incidence of relapse and non-relapse mortality at 3 yr was similar among different donor types. Subsequent multivariable analyses showed that the sex of the patient (male) and a high/very high disease risk index were independently associated with poorer DFS and OS, while the donor type was not.CONCLUSION: T-cell replete HCT from HIDs using an ATG-containing reduced intensity conditioning regimen may be a reasonable option in the absence of matched related donors in patients with acute leukemia or myelodysplastic syndrome.


Assuntos
Soro Antilinfocitário , Bussulfano , Transplante de Células , Intervalo Livre de Doença , Humanos , Incidência , Leucemia , Mortalidade , Síndromes Mielodisplásicas , Recidiva , Estudos Retrospectivos , Linfócitos T , Doadores de Tecidos , Transplantes , Doadores não Relacionados
10.
Blood Research ; : 57-61, 2020.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-820802

RESUMO

BACKGROUND: Autologous stem cell transplantation (autoSCT) can extend remission of mantle cell lymphoma (MCL), but the management of subsequent relapse is challenging.METHODS: We examined consecutive patients with MCL who underwent autoSCT at Veterans Affairs Puget Sound Health Care System between 2009 and 2017 (N=37).RESULTS: Ten patients experienced disease progression after autoSCT and were included in this analysis. Median progression free survival after autoSCT was 1.8 years (range, 0.3–7.1) and median overall survival after progression was only 0.7 years (range, 0.1 to not reached). The 3 patients who survived more than 1 year after progression were treated with ibrutinib.CONCLUSION: Our findings suggest that ibrutinib can achieve relatively prolonged control of MCL progressing after autoSCT.


Assuntos
Assistência à Saúde , Progressão da Doença , Intervalo Livre de Doença , Humanos , Linfoma de Célula do Manto , Recidiva , Transplante de Células-Tronco , Células-Tronco , Veteranos
11.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-811413

RESUMO

We present an 8 years old girl who was diagnosed at 6 months of age of Progressive Familial Intrahepatic Cholestasis type 2. Although liver transplantation (LT) was classically considered curative for these patients, cholestasis recurrence with normal gamma-glutamyl transpeptidase (GGT), mediated by anti-bile salt export pump (BSEP) antibodies after LT (auto-antibody Induced BSEP Deficiency, AIBD) has been recently reported. Our patient underwent LT at 14 months. During her evolution, patient presented three episodes of acute rejection. Seven years after the LT, the patient presented pruritus with cholestasis and elevation of liver enzymes with persistent normal GGT. Liver biopsy showed intrahepatic cholestasis and giant-cell transformation with very low BSEP activity. Auto-antibodies against BSEP were detected therefore an AIBD was diagnosed. She was treated with Rituximab and immunoadsorption with resolution of the AIBD. As a complication of the treatment she developed a pneumocystis infection successfully treated with corticoids, cotrimoxazol and anidulafungin.


Assuntos
Corticosteroides , Anticorpos , Bile , Biópsia , Criança , Colestase , Colestase Intra-Hepática , Feminino , gama-Glutamiltransferase , Humanos , Transplante de Fígado , Fígado , Infecções por Pneumocystis , Prurido , Recidiva , Rituximab
12.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-811412

RESUMO

Giant cell hepatitis with autoimmune hemolytic anemia (AHA) is a rare disease of infancy characterized by the presence of both Coombs-positive hemolytic anemia and progressive liver disease with giant cell transformation of hepatocytes. Here, we report a case involving a seven-month-old male infant who presented with AHA followed by cholestatic hepatitis. The clinical features included jaundice, pallor, and red urine. Physical examination showed generalized icterus and splenomegaly. The laboratory findings suggested warm-type AHA with cholestatic hepatitis. Liver biopsy revealed giant cell transformation of hepatocytes and moderate lobular inflammation. The patient was successfully treated with four doses of rituximab. Early relapse of hemolytic anemia and hepatitis was observed, which prompted the use of an additional salvage dose of rituximab. He is currently in clinical remission.


Assuntos
Anemia Hemolítica , Anemia Hemolítica Autoimune , Biópsia , Células Gigantes , Hepatite , Hepatócitos , Humanos , Lactente , Inflamação , Icterícia , Fígado , Hepatopatias , Masculino , Palidez , Exame Físico , Doenças Raras , Recidiva , Rituximab , Esplenomegalia
13.
Korean Circulation Journal ; : 346-357, 2020.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-811365

RESUMO

BACKGROUND AND OBJECTIVES: The objective of this study was to evaluate the long-term clinical outcomes and the incidence of permanent pacemaker implantation after catheter ablation in patients with of atrial fibrillation (AF) and sinus node dysfunction (SND).METHODS: Among 3,068 total consecutive patients who underwent AF catheter ablation (AFCA), this study included 222 (9.5%; men 53.2%, 63.7±9.2 years of age, 81.5% paroxysmal AF) with underlying SND and a regular rhythm follow-up. We analyzed the rhythm outcomes, changes in the mean heart rate or heart rate variability, and permanent pacemaker implantation rate.RESULTS: During 47.5±28.8 months of follow-up, 25 (11.3%) patients received pacemaker implantations due to symptomatic SND. More than half (56.0%, 14/25) underwent a pacemaker implantation within 3 months of the AFCA, and the annual pacemaker implantation rate was 2.0% afterwards. Both the early (68.0% vs. 31.0%, p<0.001) and clinical AF recurrence (68.0% vs. 32.5%, p=0.001) rates and continuous antiarrhythmic drug use after 3 months (44.0% vs. 24.4%, p=0.036) were significantly higher in patients requiring pacemaker implantations than those that did not. An anterior linear ablation (odds ratio [OR], 9.37 [3.03–28.9]; p<0.001) and the E/Em (OR, 1.15 [1.02–1.28]; p=0.018) were independently associated with permanent pacemaker implantations after AFCA in patients with AF and SND.CONCLUSIONS: After AFCA in patients with AF and SND, 1 of 9 patients needed a pacemaker implantation and half needed implantations within 3 months. The AF recurrence rate was significantly higher in those who required pacemaker implantations after the AFCA.


Assuntos
Fibrilação Atrial , Ablação por Cateter , Cateteres , Seguimentos , Frequência Cardíaca , Humanos , Incidência , Masculino , Marca-Passo Artificial , Recidiva , Síndrome do Nó Sinusal , Nó Sinoatrial
14.
Artigo em Coreano | WPRIM (Pacífico Ocidental) | ID: wprim-811324

RESUMO

PURPOSE: To evaluate the effectiveness of 0.1% topical bromfenac as an adjunctive treatment with intravitreal bevacizumab (IVB) injection for branch retinal vein occlusion (BRVO) patients.METHODS: We retrospectively evaluated 68 eyes of 68 patients with macular edema (ME) secondary to BRVO who were treated with IVB injection and followed up for at least 12 months. Of the 68 eyes, 38 were treated with IVB combined with 0.1% topical bromfenac and 30 were treated with IVB alone. IVB reinjection was performed in cases of recurrence. The primary outcome measurement was the number of IVB injections. Changes in the best-corrected visual acuity (BCVA) and central foveal thickness (CFT) during the 12-month follow-up were compared.RESULTS: There was no significant difference in the BCVA or CFT between the two groups at the initial and final examinations. However, the number of IVB injections was significantly lower in the 0.1% bromfenac-treated eyes (p < 0.01) than in the control eyes (4.1 ± 0.7 vs. 5.0 ± 0.6 times).CONCLUSIONS: Compared to IVB monotherapy, topical bromfenac as an adjunctive treatment with IVB injection of eyes with ME secondary to BRVO did not affect visual outcomes, but it reduced the number of IVB injections.


Assuntos
Bevacizumab , Seguimentos , Humanos , Edema Macular , Recidiva , Oclusão da Veia Retiniana , Veia Retiniana , Retinaldeído , Estudos Retrospectivos , Acuidade Visual
15.
Artigo em Coreano | WPRIM (Pacífico Ocidental) | ID: wprim-811321

RESUMO

PURPOSE: To report a case of Epstein-Barr virus-related corneal endotheliitis accompanied by secondary glaucoma.CASE SUMMARY: A 73-year-old male presented with blurred vision in his right eye. In the ophthalmic evaluation, there were dispersed keratic precipitates overlying corneal edema. The anterior chamber showed trace ~1+ graded inflammation and an endothelial density decrease. His best-corrected visual acuity and intraocular pressure in the right eye were 0.2 and 34 mmHg, respectively. Paracentesis was performed on the anterior chamber of the right eye to confirm the diagnosis under the suspicion of corneal endotheliitis with trabeculectomy for the intraocular pressure control. Epstein-Barr virus was confirmed using a multiplex polymerase chain reaction (PCR), and oral and eye drops of Acyclovir were used to treat the patient. There was no evidence of a recurrence over 2 years and his intraocular pressure was 12 mmHg and best-corrected visual acuity was maintained at 0.5.CONCLUSIONS: A case of Epstein-Barr virus-related corneal endotheliitis was diagnosed using PCR of the aqueous humor. The patient was treated with an oral antiviral agent and eyedrops without a recurrence.


Assuntos
Aciclovir , Idoso , Câmara Anterior , Humor Aquoso , Edema da Córnea , Diagnóstico , Glaucoma , Herpesvirus Humano 4 , Humanos , Inflamação , Pressão Intraocular , Masculino , Reação em Cadeia da Polimerase Multiplex , Soluções Oftálmicas , Paracentese , Reação em Cadeia da Polimerase , Recidiva , Trabeculectomia , Acuidade Visual
16.
Artigo em Coreano | WPRIM (Pacífico Ocidental) | ID: wprim-811316

RESUMO

PURPOSE: We determined whether elevated serum alkaline phosphatase (ALP) was related to prevalence, location, type, length, and recurrence of pterygium in a population from the Republic of Korea.METHODS: A nationwide cross-sectional dataset, the Korean National Health and Nutrition Examination Survey (2008–2011), was used in this study. All participants were > 30 years of age and underwent the ALP test and ophthalmic evaluation (n = 22,359). One-way analysis of variance, the chi-square test, and Fisher's exact test were used to compare characteristics and outcomes among participants. Multivariable logistic regression was used to examine the possible associations between serum ALP levels and various types of pterygium. Data were adjusted for known risk factors for development of pterygium and ALP elevation (age, sex, residence, sunlight exposure, drinking, smoking, hypertension, diabetes, BMI, AST, ALT, vitamin D, and HDL).RESULTS: The overall prevalence of pterygium was 8.1%, and participants with pterygium had higher levels of serum ALP (p < 0.001). Participants with higher serum ALP had a significantly higher prevalence of all types of pterygium than those in the lower serum ALP quartiles. After adjusting for potential confounding factors, multivariate logistic regression analysis revealed that ALP was associated with the prevalence of pterygium (odds ratio [OR], 1.001; p = 0.038). Trend analysis between the OR and ALP quartiles revealed a linear trend in overall prevalence and in the intermediate type of pterygium. Subgroup analysis revealed a stronger correlation in participants > 50 years of age. One-way analysis of variance revealed an association between the size of pterygium and serum ALP quartile levels. Serum ALP was not associated with recurrence of pterygium.CONCLUSIONS: Increased serum ALP was associated with the prevalence and size of pterygium.


Assuntos
Fosfatase Alcalina , Estudos Transversais , Conjunto de Dados , Ingestão de Líquidos , Hipertensão , Coreia (Geográfico) , Modelos Logísticos , Inquéritos Nutricionais , Prevalência , Pterígio , Recidiva , República da Coreia , Fatores de Risco , Fumaça , Fumar , Luz Solar , Vitamina D
17.
Artigo em Coreano | WPRIM (Pacífico Ocidental) | ID: wprim-811311

RESUMO

PURPOSE: To compare the efficacy of intravitreal dexamethasone implants according to previous response to bevacizumab treatment in patients with diabetic macular edema (DME).METHODS: Forty-nine eyes of 49 patients who received intravitreal dexamethasone implants for DME were reviewed retrospectively. Of these patients, 13 were treatment-naïve and 36 had previously received intravitreal injections of bevacizumab. Of the 36 previously treated patients, 24 comprised a refractory group showing no response to previous injections, and 12 comprised a responder group showing a response to previous treatments. The best-corrected visual acuity, central macular thickness (CMT), and retreatment percentages were assessed monthly for 6 months.RESULTS: After the intravitreal dexamethasone implants, visual acuity improved significantly over 6 months in the treatment-naïve group, while in the responder group, a significant improvement in visual acuity was seen at the 2-month follow-up. In the refractory group, there was no significant improvement in visual acuity during the follow-up period. The CMT showed a significant decrease in all three groups, and there was no significant difference in the CMT among the three groups at any time point. Five patients in the treatment-naive group (38.5%), 19 patients in the refractory group (79.2%), and nine patients in the responder group (75.0%) needed retreatment for recurrent macular edema, and there was a significant difference among the three groups in the rate of recurrence (p = 0.034).CONCLUSIONS: In DME patients, intravitreal dexamethasone implants were associated with a significant anatomical improvement irrespective of previous bevacizumab treatment response. However, the treatment-naïve and responder groups showed improvements in visual acuity, whereas the refractory group showed limited improvement.


Assuntos
Bevacizumab , Dexametasona , Seguimentos , Humanos , Injeções Intravítreas , Edema Macular , Recidiva , Retratamento , Estudos Retrospectivos , Acuidade Visual
18.
Artigo em Coreano | WPRIM (Pacífico Ocidental) | ID: wprim-811307

RESUMO

PURPOSE: We sought factors affecting amblyopia recurrence after successful treatment.METHODS: We included 117 patients with amblyopia. Patients were divided into recurrence and non-recurrence groups. We analyzed sex, age, amblyopia type, treatment duration, visual acuity, and binocular status.RESULTS: Of the 117 patients, 25 (21.4%) experienced recurrences. In that group, 60.0% of patients (compared to 14.1% of the no-recurrence group) exhibited high-frequency strabismus (p < 0.001). The recurrence group were younger than the no-recurrence group at both the beginning and end of treatment (p < 0.05). None of visual acuity at treatment commencement or end, stereoacuity, or suppression affected amblyopia recurrence.CONCLUSIONS: Recurrent amblyopia is frequent after initial successful treatment if the patient exhibits strabismus or is young.


Assuntos
Ambliopia , Humanos , Recidiva , Fatores de Risco , Estrabismo , Telescópios , Acuidade Visual
19.
Artigo em Coreano | WPRIM (Pacífico Ocidental) | ID: wprim-811300

RESUMO

With technical advances in computed tomography and the introduction of non-ionic low- or iso-osmolar iodinated contrast media (ICM), the use of ICM and the occurrence of ICM-related hypersensitivity reactions (HSRs) has rapidly increased. Although ICM-related HSRs are known to be mild, they still represent life-threatening events in rare instances. It is therefore important to prevent recurrent HSRs in high-risk patients. Changing the culprit contrast agent is a powerful known tool for reducing the recurrence rate of HSRs. Based on the large body of evidence, the American College of Radiology manual on contrast media (latest version 10.3) suggests that changing the ICM within the same class may help reduce the likelihood of a subsequent contrast reaction. Furthermore, the European Society of Urogenital Radiology guidelines on contrast agents (latest version 10) also recommends using a different contrast agent with previous contrast agent reactors to reduce the risk of an acute reaction. In this article, we review the necessity and clinical efficacy of changing the culprit ICM for high-risk patients at the time of re-exposure to prevent ICM-related HSRs and minimize the risk of fatality.


Assuntos
Meios de Contraste , Humanos , Hipersensibilidade , Prevenção Primária , Recidiva , Resultado do Tratamento
20.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-811267

RESUMO

Hydatid disease is a zoonotic infection in humans. The disease is endemic in some parts of the world, including Africa, Australia, and Asia, where cattle grazing is common; the disease is spread by an enteric route following the consumption of food contaminated with the eggs of the parasite. Failure to identify this parasite results in delayed diagnosis and increased morbidity to the patient. Upon diagnosis, every possible step should be taken, both surgical and medical, to prevent anaphylactic reactions from the cystic fluid. Postsurgical long-term follow up along with periodical ultrasonography of the liver and computed tomography scan of the abdomen is essential to rule out possible recurrence.


Assuntos
Abdome , África , Anafilaxia , Animais , Ásia , Austrália , Bovinos , Diagnóstico Tardio , Diagnóstico , Equinococose , Ovos , Seguimentos , Humanos , Fígado , Óvulo , Parasitos , Recidiva , Ultrassonografia , Zoonoses
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA