ABSTRACT
CASE REPORT: We present the case of a patient operated on for extracapsular cataract extraction of both eyes. Three weeks after the first operation (right eye), the patient presented a local inflammatory reaction at the incision site which was characterized by the existence of whitish exudates of different sizes surrounding the nylon suture. At one week of the second operation, the patient presented the same alteration (left eye), although it was observed sooner and had a greater intensity. The allergy skin tests for nylon and other substances were negative, however the local inflammatory reaction disappeared when the nylon suture was removed. DISCUSSION: This type of reaction, which we have observed in several other patients, has been previously described by others authors, although no clearly established cause has been demonstrated. Both toxicity and allergy to nylon have been proposed as the underlying mechanisms. We consider that a type IV hypersensitivity reaction to nylon may be the underlying mechanism of these reactions although toxicity cannot be ruled out.
Subject(s)
Cataract Extraction , Drug Hypersensitivity/etiology , Keratitis/etiology , Limbus Corneae/pathology , Nylons/adverse effects , Postoperative Complications/etiology , Sutures , Exudates and Transudates , Humans , Male , Middle AgedABSTRACT
Caso clínico: Presentamos el caso de un paciente intervenido de cirugía extracapsular de catarata de ambos ojos. Tres semanas después de la primera intervención (OD), presentó una inflamación localizada en la zona adyacente a la sutura y caracterizada por la existencia de unos exudados blanquecinos de diferentes tamaños en torno al hilo de sutura. A la semana de practicar la segunda intervención (OI), presentó la misma alteración, aunque más precoz y de mayor intensidad. Las pruebas alérgicas al nylon y a otras substancias fueron negativas, pero el cuadro se resolvió al retirar el nylon. Discusión: Este tipo de reacción, que hemos observado en otros pacientes ha sido descrito previamente en la literatura sin que se haya podido demostrar su etiología de forma concluyente. Existe controversia en la bibliografía sobre si su mecanismo patogénico se debe a una supuesta toxicidad al nylon o alergia al mismo. Por nuestra parte, pensamos que este tipo de reacciones puede deberse a una etiología alérgica mediada por hipersensibilidad tipo IV, aunque no podemos descartar un mecanismo tóxico. (AU)
Subject(s)
Middle Aged , Male , Humans , Sutures , Cataract Extraction , Limbus Corneae , Nylons , Postoperative Complications , Drug Hypersensitivity , Keratitis , Exudates and TransudatesABSTRACT
Objetivo/Métodos: Presentamos el caso de una paciente de 71 años con un carcinoma escamoso de conjuntiva con invasión escleral y orbitaria. A pesar de que el estudio citológico no fue concluyente, debido a la sospecha de invasión del recto inferior, optamos por la realización de una enucleación ampliada. Resultado/Conclusiones: El estudio histopatológico es el factor más importante a la hora de decidir la actitud terapéutica en este tipo de tumores, si bien han de considerarse otros aspectos clínicos que pueden modificar la pauta terapéutica más apropiada para cada paciente (AU)
Subject(s)
Aged , Female , Humans , Neoplasm Invasiveness , Carcinoma, Squamous Cell , Neoplasms, Multiple Primary , Orbital Neoplasms , Conjunctival NeoplasmsABSTRACT
The bad use and overload of hospital emergency rooms (HER) constitute a problem in present health assistance. Old patients are often blamed of a misuse of this health care assistance. The results of studies analyzing the behaviour of older patients at HER show that this group of patients utilize this service more adequately than younger adults, since they go to the emergency room with more justifiable reason, with more severe diseases and require more hospital admissions. On the other hand, older patients consume more time in the HER than what would proportionally correspond to this group in the community. It is interesting to keep these data in mind when planning health assistance.
