ABSTRACT
PURPOSE: We present the case of an 18-year-old Caucasian male with a unilateral macular star and retinal vascular anomalies compatible with adult onset Coats' disease. METHODS: Diagnosis was based on fundoscopic, fluorescein angiography and optical coherence tomography findings. RESULTS: The patient presented to our emergency department with complaints of low vision in his left eye (LE) detected 10 days before. The best-corrected visual acuity in the LE was 20/50. Fundoscopy of the LE evidenced a complete macular star. Optical coherence tomography showed increased retinal thickness, infiltration of the retinal wall, and detachment of the neuroepithelium. Angiography revealed no appreciable diffusion in the macula. Above the superior temporal (ST) arcade, anomalies in the retinal vasculature were found, with interruption of the peripheral vessels and vessels which were 'sausage'-like. After 1 month, the LE vision evolved to hand movements. Laser photocoagulation was performed in the ST quadrant. Intravitreal injection of bevacizumab 1.25 mg/0.05 ml and photodynamic therapy were performed without any significant changes, progression of ST serous detachment of the neuroepithelium, and finally progression to macular fibrosis. DISCUSSION: Coats' disease is usually diagnosed in childhood, but rare cases may occur in adults. Those cases usually have a more indolent course which was not observed in our patient. When there is macular involvement, prognosis is more guarded, despite treatment.
ABSTRACT
A biossegurança é o conjunto de ações voltadas para a prevenção, minimização ou eliminação de riscos que possam comprometer a saúde do homem e dos animais e o meio ambiente. Os primeiros debates sobre a biossegurança tiveram início na década de 1970, devido a preocupações com a segurança nos espaços laboratoriais e com as consequências que os constantes avanços tecnológicos na área de engenharia genética poderiam significar para o homem, bem como para os sistemas ecológicos. No Brasil, a regulamentação para atividades relacionadas a essas áreas teve início em 1995, com a criação da Comissão Técnica Nacional de Biossegurança. Suas funções são fiscalizar a manipulação de organismos geneticamente modificados (OGM) e certificar a segurança dos espaços laboratoriais. Este trabalho tem como finalidade disseminar os conceitos de biossegurança e proporcionar informações que auxiliarão na segurança do homem e do meio ambiente em aspectos relacionados às atividades de pesquisa, produção, ensino, desenvolvimento tecnológico e prestação de serviços.
Biosafety is a set of actions directed to the prevention, minimization or elimination of risks that could jeopardize the human's and animal's health and of the environment. The first debates about biosafety were held in the early 1970's due to the outbreak of transmissible diseases and to the concern to the safety in laboratory arenas. In Brazil, the regulations to activities related to these areas began in 1995 with the formation of the National Technical Biosafety whose functions are the inspection of the manipulated Genetically Modified Organisms (GMO) and of the laboratory arena safety. This review describes the biosafety concepts and their applicability known in order to improve the human safety as well as the environment in related issues to the research activities, production, teaching, technological development and given service.
Subject(s)
Containment of Biohazards/methods , Containment of Biohazards/standards , Containment of Biohazards/trends , Organisms, Genetically ModifiedABSTRACT
Two patients experienced agranulocytosis associated with either procainamide or trimethoprim-sulfamethoxazole. Both were treated with filgrastim in an attempt to decrease the duration of agranulocytosis. The first patient received 12 days and the second patient 4 days of filgrastim before white blood cell counts recovered. Published reports both support and refute the efficacy of filgrastim in this setting. The agent may be beneficial in certain cases of this disorder, but further investigation is necessary to determine if it has a definitive role.
