ABSTRACT
This is a case report involving 3 siblings, ages 22, 21, and 3 years old, of consanguineous parents and Syrian descent with a particularly unique clinical phenotype and eyelid/gingival findings that have not been previously characterized. Full-thickness eyelid biopsies for 2 of the siblings were evaluated by ophthalmic pathology showed generalized fibrosis without any active destructive process or amyloid. Three of the 9 siblings were affected by this order with no familial history. Ophthalmic plastic surgeons should be aware of this new entity as genetic localization and further identification may help families affected by this disorder.
Subject(s)
Siblings , Fibrosis , Humans , Phenotype , SyndromeABSTRACT
PURPOSE: This study evaluated the long-term outcomes of the Misago peripheral stent trial (Terumo) for atherosclerotic lesions in the superficial femoral artery (SFA) in patients with claudication. MATERIALS AND METHODS: This was a prospective multicenter, single-arm, clinical trial of primary stent placement for de novo cases of SFA disease conducted in the United States and Asia. The primary endpoint was freedom from clinically driven target lesion revascularization (CD-TLR) at 36 months. Secondary outcomes were ankle-brachial index (ABI), Rutherford score, Walking Impairment Questionnaire (WIQ), a quality of life survey, and rate of device fracture. RESULTS: A total of 276 patients (64.4% male; mean age, 69.3 ± 10.1 years) were enrolled. Freedom from CD-TLR was 78.5% (95% confidence interval [CI], 73.0%-83.0%) at 24 months and 75.4% (95% CI, 69.6%-80.2%) at 36 months. Baseline ABI was 0.7 ± 0.1 and 0.98 ± 0.20 (P < .001) at 30 days after the procedure. Baseline Rutherford score was 3.6 ± 0.6 and 1.6 ± 1.0 30 at 30 days after the procedure (P < .001). Mean (and changed) ABI and Rutherford score at 36 months compared to day 30 after the procedure were, respectively, 0.91 (-0.1 ± 0.2) and 1.5 (-0.2 ± 1.1). WIQ score at baseline was 21.49 ± 26.30 and 50.51 ± 38.49 at 30 days after the procedure ( P < .001). The mean WIQ score at 2 years was 46.65 ± 37.31 (P = .12). Stent fracture rate at 36 months was 2.0% (4 of 202 patients). CONCLUSIONS: OSPREY (Occlusive-Stenotic Peripheral Artery Revascularization Study) 36-month data demonstrated persistent freedom from CD-TLR and sustained improvement in ABI and Rutherford score with primary stent placement for SFA lesions.
Subject(s)
Endovascular Procedures/instrumentation , Femoral Artery , Intermittent Claudication/therapy , Peripheral Arterial Disease/therapy , Self Expandable Metallic Stents , Aged , Aged, 80 and over , Ankle Brachial Index , Asia , Endovascular Procedures/adverse effects , Female , Femoral Artery/diagnostic imaging , Femoral Artery/physiopathology , Humans , Intermittent Claudication/diagnosis , Intermittent Claudication/physiopathology , Male , Middle Aged , Peripheral Arterial Disease/diagnosis , Peripheral Arterial Disease/physiopathology , Prospective Studies , Prosthesis Design , Prosthesis Failure , Quality of Life , Recovery of Function , Time Factors , Treatment Outcome , United States , Vascular PatencySubject(s)
Decompression, Surgical , Graves Disease/diagnostic imaging , Oculomotor Muscles/diagnostic imaging , Orbital Diseases/diagnostic imaging , Cone-Beam Computed Tomography , Female , Graves Disease/pathology , Graves Disease/surgery , Humans , Middle Aged , Orbital Diseases/pathology , Orbital Diseases/surgeryABSTRACT
An 87-year-old patient presented with a 6-week history of an isolated progressive destructive nodular eyelid mass, secondary nodular and ulcerative lesions, and regional painful lymphadenopathy. After 4 weeks, fungal cultures demonstrated Sporothrix schenckii. S. schenckii is a rare dimorphic fungus that can occasionally involve the periocular skin. The authors' case demonstrates typical clinical features, emphasizes the delay in diagnosis, and shows effective treatment with oral itraconazole.
Subject(s)
Dermatomycoses/diagnosis , Eye Infections, Fungal/diagnosis , Eyelid Diseases/diagnosis , Sporothrix/isolation & purification , Sporotrichosis/diagnosis , Aged, 80 and over , Antifungal Agents/therapeutic use , Dermatomycoses/drug therapy , Dermatomycoses/microbiology , Eye Infections, Fungal/drug therapy , Eye Infections, Fungal/microbiology , Eyelid Diseases/drug therapy , Eyelid Diseases/microbiology , Female , Humans , Itraconazole/therapeutic use , Sporotrichosis/drug therapy , Sporotrichosis/microbiologyABSTRACT
Factor XI deficiency is a rare coagulopathy that requires a specific approach to preoperative planning. Herein we report a case where ophthalmic surgery led to this diagnosis in a 4-month old boy and review the warranted prophylactic measures prior to operative intervention.
