RESUMEN
Full-thickness macular hole is a rare complication of macular telangiectasia type 2, and its treatment is still controversial. A patient with a full-thickness macular hole secondary to macular telangiectasia type 2 underwent vitreoretinal surgery with a plasma rich in growth factors membrane in the macular hole. At the sixth month of follow-up, anatomical and functional improvements were achieved, with no adverse effects. Plasma rich in growth factors is a new option, with advantages due to its biological properties that achieves good results in terms of safety and effectiveness in the surgical treatment of macular hole.
Asunto(s)
Perforaciones de la Retina , Telangiectasia Retiniana , Humanos , Perforaciones de la Retina/etiología , Perforaciones de la Retina/cirugía , Telangiectasia Retiniana/complicaciones , Telangiectasia Retiniana/terapia , Vitrectomía/métodosRESUMEN
El agujero macular de espesor total es una complicación rara de la telangiectasia macular tipo 2, y su tratamiento es aún controvertido. Una paciente con esta entidad fue llevada a cirugía vitreorretiniana con aplicación de membrana de plasma rico en factores de crecimiento sobre el agujero macular. Al sexto mes de cirugía se logró mejoría anatómica y funcional, sin efectos adversos asociados. El plasma rico en factores de crecimiento es una alternativa nueva en el tratamiento quirúrgico del agujero macular atípico y/o persistente, que logra buenos resultados en términos de seguridad efectividad, debido a sus propiedades biológicas (AU)
Full-thickness macular hole is a rare complication of macular telangiectasia type 2, and its treatment is still controversial. A patient with a full-thickness macular hole secondary to macular telangiectasia type 2 underwent vitreoretinal surgery with a plasma rich in growth factors membrane in the macular hole. At the sixth month of follow-up, anatomical and functional improvements were achieved, with no adverse effects. Plasma rich in growth factors is a new option, with advantages due to its biological properties that achieves good results in terms of safety and effectiveness in the surgical treatment of macular holey (AU)
Asunto(s)
Humanos , Femenino , Anciano , Perforaciones de la Retina/etiología , Perforaciones de la Retina/cirugía , Telangiectasia Retiniana/complicaciones , Cirugía Vitreorretiniana/métodos , Factores de Crecimiento Transformadores/administración & dosificación , Plasma , Resultado del TratamientoRESUMEN
Full-thickness macular hole is a rare complication of macular telangiectasia type 2, and its treatment is still controversial. A patient with a full-thickness macular hole secondary to macular telangiectasia type 2 underwent vitreoretinal surgery with a plasma rich in growth factors membrane in the macular hole. At the sixth month of follow-up, anatomical and functional improvements were achieved, with no adverse effects. Plasma rich in growth factors is a new option, with advantages due to its biological properties that achieves good results in terms of safety and effectiveness in the surgical treatment of macular hole.
RESUMEN
In this report, we explore retinoblastoma diagnostic accuracy and review chemotherapy alternatives for retinoblastoma using intravenous, intra-arterial, periocular, and intravitreal routes. A review of 2775 patients referred for management of retinoblastoma, disclosed 78% with confirmed retinoblastoma and 22% with simulating lesions, termed pseudoretinoblastomas. Children ≤2 years old showed leading pseudoretinoblastomas of persistent fetal vasculature, Coats disease, and vitreous haemorrhage, whereas those >5 years showed simulators of Coats, toxocariasis, and familial exudative vitreoretinopathy. The diagnosis of retinoblastoma should be established before planning therapeutic strategy. Chemotherapy strategy depends on tumour laterality and stage of disease. If bilateral retinoblastoma, intravenous chemotherapy (IVC) is important as first-line therapy for control of intraocular disease, prevention of metastasis, and reduction in prevalence of pinealoblastoma and long-term second malignant neoplasms. Bilateral groups D and E retinoblastoma receive additional subtenon's carboplatin boost for improved local control. If unilateral disease is present, then intra-arterial chemotherapy (IAC) is often considered. IAC can be salvage therapy following chemoreduction failure. Unilateral retinoblastoma of groups D and E are managed with enucleation or globe-conserving IVC and/or IAC. Intravitreal chemotherapy is cautiously reserved for recurrent vitreous seeds following other therapies. In conclusion, the strategy for retinoblastoma management with chemotherapy depends on tumour laterality and stage of disease. Bilateral retinoblastoma is most often managed with IVC and unilateral retinoblastoma with IAC, but if advanced stage, combination IVC plus IAC or enucleation.
Asunto(s)
Antineoplásicos/administración & dosificación , Neoplasias de la Retina/tratamiento farmacológico , Retinoblastoma/tratamiento farmacológico , Humanos , Inyecciones Intraarteriales , Inyecciones Intraoculares , Inyecciones Intravenosas , Inyecciones Intravítreas , Neoplasias de la Retina/diagnóstico , Retinoblastoma/diagnósticoRESUMEN
Four new cases of carotid body tumors are reported, all familial, including 2 patients with bilateral tumors. The embryology, physiology, pathology, natural history, and treatment of these rare tumors are reviewed. It is recommended that all carotid body tumors be excised unless there are contraindicating medical or technical reasons.
Asunto(s)
Enfermedades de las Arterias Carótidas/genética , Tumor del Cuerpo Carotídeo/genética , Neoplasias de Cabeza y Cuello/genética , Adulto , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
A technique for covering areas of osteoradionecrosis in the medial aspect of the chest wall has been described. Utilizing a tissue expander, the skin was stretched sufficiently to obtain a suitable length whereby the medial defect could be covered and the donor site closed primarily. Such an operative approach should be considered when the patient presents with a medially located ulcer of small to moderate size and when nonirradiated skin is regionally available. Using this technique, long myocutaneous flaps that require extensive dissection, loss of functioning muscle, and resulting donor defects are avoided.
Asunto(s)
Mastectomía , Osteorradionecrosis/cirugía , Traumatismos por Radiación/cirugía , Colgajos Quirúrgicos , Cirugía Torácica/métodos , Neoplasias de la Mama/diagnóstico por imagen , Neoplasias de la Mama/cirugía , Femenino , Humanos , Persona de Mediana Edad , Radiografía , Costillas/cirugíaRESUMEN
Admission blood alcohol levels (BAL) were obtained in 111 adult passenger/driver pairs injured in vehicular crashes. Drinking patterns were studied, including the influence of the sex of the occupants on alcohol consumption. Alcohol was not a factor in 44 of the crashes. In 48 of 62 crashes (77%), the driver was either the sole drinker or had a higher BAL than the passenger. In five crashes, the passenger was the only drinker. Female drivers were drinking 40% of the time, compared to 60% of male drivers. Overall, 77.4% of the drinking drivers had a BAL of greater than or equal to 100 mg/100 ml. When vehicular occupants were of the same sex, as opposed to both sexes, the drivers drank more frequently (62.9% vs. 43.9%). In 13 of 14 cases of a drinking male driver transporting a female passenger, the female passenger had not been drinking or had done so to a lesser degree. The data indicate that educational efforts should be directed at discouraging passengers from riding with drinking drivers.