Subject(s)
Carcinoma, Neuroendocrine/diagnosis , Headache/diagnosis , Ophthalmoplegia/diagnosis , Paranasal Sinus Neoplasms/diagnosis , Sphenoid Sinus/pathology , Aged , Carcinoma, Neuroendocrine/complications , Diagnosis, Differential , Fatal Outcome , Headache/etiology , Humans , Male , Ophthalmoplegia/etiology , Paranasal Sinus Neoplasms/complications , Sphenoid Sinus/diagnostic imagingABSTRACT
INTRODUCTION: Multifocal choroidal ischemia is a complication of severe hypertension, notably in preeclampsia. It is a rare phenomenon due to multiple choriocapillaris occlusions. CLINICAL OBSERVATIONS: We report the cases of two patients, age 28 and 32 years, 34 and 26 weeks since last menstrual period, respectively. The first had controlled preeclampsia under treatment. The second had developed Hemolysis, Elevated Liver enzymes, Low Platelet count (HELLP) syndrome complicated by in utero fetal death. Both patients reported visual loss. Comprehensive ophthalmological examination and fluorescein angiography confirmed the diagnosis of multifocal choroidal ischemia, in the acute stage in the first patient and cicatricial in the second. CONCLUSION: Acute choroidal ischemia is an ocular vascular syndrome which must be ruled out by systematic examination in any preeclamptic patient, so as to make the diagnosis and begin treatment early.
Subject(s)
Choroid/blood supply , Ischemia/complications , Pre-Eclampsia , Adult , Female , Humans , Ischemia/diagnosis , PregnancyABSTRACT
OBJECTIVE: To establish the epidemiologic profile of holoprosencephalia and determine benefits of ultrasound and foetopathologic examination to the diagnostic. METHODS AN MATERIAL: [corrected] Retrospective study about 17 cases of holoprosencephalia observed in CMNT between Janaury 1992 and September 2000. RESULTS: Ultrasound diagnosis was made in 13 cases (75%). Ultrasound criteria were; absence of median structure of the brain and unique ventricule. The prognosis was always bad. Foetopathologic examination revealed 7 cases of lobar holoproencephalia and 10 of semi lobar. Fascial dysmorphia were noted in 82% of cases. CONCLUSION: The foetopathology and genetic counselling looking for fascial, dysmorphia in family's members gives a good evaluation of recurrences.
Subject(s)
Holoprosencephaly/diagnostic imaging , Ultrasonography, Prenatal , Adult , Chromosome Aberrations , Face/abnormalities , Female , Holoprosencephaly/genetics , Holoprosencephaly/pathology , Humans , Infant, Newborn , Male , Pregnancy , Prognosis , Retrospective StudiesABSTRACT
The omphalocele is an average coelosomie, frequency of which is estimated at 1/5000 births. We confront diagnosis antenatal with the exam foetopathologic in purpose of 41 cases of omphalocele brought together over a period going from January 1, 1991 till December, 2000 in the unity of foetopathologie from the CMNT. The frequency of omphaloceles is 4.88% of the children malformed and of 1.64% of the set (group) of the performed an autopsy children. An association malformative was found in 85.4% of cases and a karyotype typical aberration trisomie 13.18 and 21 was identified in 17% of cases. The preview of the children bearers of this deformation is especially bound (connected) to the existence and to the gravity of associated abnormalities. The omphalocele required a multidisciplinary making coverage intervernir obstetriciens, néonatologistes, surgeons pediatre and foetopathologistes.
Subject(s)
Abnormalities, Multiple , Chromosome Aberrations , Hernia, Umbilical/diagnosis , Prenatal Diagnosis , Adult , Autopsy , Female , Hernia, Umbilical/complications , Hernia, Umbilical/pathology , Humans , Incidence , Infant, Newborn , Karyotyping , Male , Pregnancy , Ultrasonography, PrenatalABSTRACT
OBJECTIVE: To evaluate the patient satisfaction as a performance indicator of quality of health care delivery in outpatient cataract surgery. PATIENTS AND METHODS: We performed a prospective study using a questionnaire containing 14 items (preoperative work-up, administrative formalities, local anesthesia..) evaluating all the phases of ambulatory surgery for cataract. RESULTS: We collect 75 responding patients and we observed 2/3 of relative satisfaction about outpatient cataract surgery. Negative opinion was in relation with the prolonged time required for preoperative work-up which is done outside the outpatient surgery structure. CONCLUSION: Advances in techniques of locoregional anesthesia and surgery permit today the frequent use of ambulatory treatment in cataract surgery. This method seems to be well accepted by patients. However the prolonged time used to do the preoperative work-up require in the future a centralisation for this procedure.
Subject(s)
Ambulatory Surgical Procedures/psychology , Cataract Extraction/psychology , Hospitals, General , Patient Satisfaction , Ambulatory Surgical Procedures/economics , Ambulatory Surgical Procedures/standards , Anesthesia, Local/psychology , Cataract Extraction/economics , Cataract Extraction/standards , Humans , Program Evaluation , Prospective Studies , Quality Indicators, Health Care , Surveys and Questionnaires , Time Factors , TunisiaABSTRACT
L'Oligaminos is sometimes discovered during echographic exploration in obstetrics. Etiology is dominated by renal malformations, obstructive myopathies and polymalformatives syndromes therapeutic interruption of pregnancy needs to be discussed in case of bilateral renal malformation.
Subject(s)
Congenital Abnormalities , Oligohydramnios/etiology , Abortion, Therapeutic , Congenital Abnormalities/diagnostic imaging , Female , Humans , Oligohydramnios/diagnostic imaging , Oligohydramnios/therapy , Pregnancy , Prenatal Care/methods , Ultrasonography, PrenatalABSTRACT
UNLABELLED: Alport's syndrome is a familial disorder characterized by progressive renal failure, sensorineural hearing loss and ocular manifestations. CASE REPORT: The authors report a case of a 13-year-old child with Alport's syndrome associated with retinal flecks. CONCLUSION: Retinal flecks are the most frequent ocular manifestation in Alport's syndrome and are a considerable help to diagnosis. They are often associated with severe renal failure.
Subject(s)
Nephritis, Hereditary/complications , Retinal Diseases/etiology , Adolescent , Diagnosis, Differential , Humans , Male , Nephritis, Hereditary/diagnosis , Renal Insufficiency , Retinal Diseases/pathologyABSTRACT
UNLABELLED: The purpose of this study is to show the result of outpatient cataract surgery and its differences or advantages with inpatient cataract surgery. PATIENTS AND METHODS: The retrospective study concern 722 consecutives patients collected from June 1995 till May 1997; 388 underwent outpatient cataract surgery and 384 underwent inpatient cataract surgery. RESULTS: There were non significant difference between the two groups in type of cataract surgery. Immediate postoperative complications and final visual acuity did not show any significant difference in both groups. CONCLUSION: This analysis shows the great advantages of this simple surgical procedure such an increase in cataract operation leading to a decrease of patients in waiting list.
Subject(s)
Ambulatory Surgical Procedures/methods , Cataract Extraction/methods , Adolescent , Adult , Aged , Aged, 80 and over , Cataract Extraction/adverse effects , Child , Child, Preschool , Female , Hospitalization , Humans , Infant , Male , Middle Aged , Retrospective Studies , Treatment Outcome , Visual Acuity , Waiting ListsABSTRACT
We present a case of foetal polycystic kidney disease diagnosed at 34 weeks of gesttion thanks to resonance imaging (MRI). MRI demonstrated enlarged foetal kidneys that were low signal intensity on T1 weighted images and high signal intensity on T2 weighted images. These MRI findings suggested a high water containing of the renal parenchyma.
Subject(s)
Fetal Diseases/diagnosis , Magnetic Resonance Imaging/methods , Polycystic Kidney, Autosomal Dominant/diagnosis , Prenatal Diagnosis/methods , Adult , Female , Fetal Death/etiology , Fetal Diseases/classification , Fetal Macrosomia/etiology , Humans , Oligohydramnios/etiology , Polycystic Kidney, Autosomal Dominant/classification , Polycystic Kidney, Autosomal Dominant/complications , Pregnancy , Pregnancy Trimester, ThirdSubject(s)
Myopia/complications , Retinal Detachment/complications , Adolescent , Adult , Aged , Child , Humans , Middle AgedABSTRACT
Leaking filtering blebs must be repaired immediately to avoid major complications such as hypotony and endophtalmitis. We report four cases of leaking filtering blebs occurring between one to six years after trabeculectomy. Revealing signs were hypotony in two cases and athalamia in two cases. Patching was done in one case and conjunctival reinforcement by rotation of conjunctival flap in 2 cases and free conjunctival graft in one case. Leaking disappeared in all the cases. Normal intraocular pressure (10-12 mmHg) was obtained in all cases except one which was achieved by rotation of conjunctival flap and complicated by retraction of conjunctiva. Conjunctival reinforcement without exicion of the bleb is an easy technique and respect the filtration site. Major complication in our patients is retraction of conjunctival flap which can be avoided by: exicion of Tenon, good fixation to the cornea, and free conjunctival graft.
