RESUMEN
Case Report A healthy 55-years-old male went to emergency due to a white infiltrate in the left eye without corneal trauma which partially responds to antibiotic treatment. The infiltrate worsened by the use of topical steroids. Direct microscopic evaluation and Gram stain are a valuable diagnostic tool for the detection of Absidia filaments. There is a successful treatment with anphotericin and posaconazole. Discussion Keratitis caused by Zygomicetes are unusual. This is a rare condition in healthy patients with no corneal trauma. The treatment with amphotericin and posaconazole are synergistic against filamentous fungi.
Asunto(s)
Absidia/aislamiento & purificación , Úlcera de la Córnea/etiología , Mucormicosis/microbiología , Absidia/efectos de los fármacos , Administración Oftálmica , Corticoesteroides/efectos adversos , Anfotericina B/uso terapéutico , Antibacterianos/uso terapéutico , Antifúngicos/uso terapéutico , Terapia Combinada , Trasplante de Córnea , Úlcera de la Córnea/tratamiento farmacológico , Úlcera de la Córnea/microbiología , Úlcera de la Córnea/cirugía , Quimioterapia Combinada , Humanos , Inmunocompetencia , Masculino , Persona de Mediana Edad , Mucormicosis/diagnóstico , Mucormicosis/tratamiento farmacológico , Soluciones Oftálmicas , Coloración y Etiquetado , Triazoles/uso terapéutico , Voriconazol/uso terapéuticoRESUMEN
CLINICAL CASE: A 5 year-old child diagnosed with moderate anisometropic amblyopia secondary to primary cyst of iris pigment epithelium. He was evaluated with ultrasound biomicroscopy (BMU) and optical coherence tomography (OCT) of anterior segment. DISCUSSION: The OCT, although with some limitations, is a useful tool to study the anterior segment. It is probably more recommendable than BMU in the childhood.
Asunto(s)
Ambliopía/etiología , Enfermedades Hereditarias del Ojo/complicaciones , Iris/anomalías , Epitelio Pigmentado Ocular/anomalías , Tomografía de Coherencia Óptica , Astigmatismo/etiología , Catarata/complicaciones , Preescolar , Enfermedades Hereditarias del Ojo/diagnóstico por imagen , Humanos , Iris/diagnóstico por imagen , Masculino , Microscopía Acústica , Epitelio Pigmentado Ocular/diagnóstico por imagen , Lámpara de HendiduraRESUMEN
CASE REPORT: A 64 year-old female with Parkinson disease treated with amantadine for two years who suddenly suffered bilateral corneal oedema. It was initially treated as herpetic endotheliitis without improvement as we lacked information on her chronic treatment. The corneal oedema finally resolved after withdrawing the drug. DISCUSSION: Amantadine hydrochloride may produce endothelial dysfunction. Once the amantadine treatment is stopped, the corneal oedema may be reversible but endothelial density remains low. An ophthalmologist examination should be performed before the initiation of amantadine treatment in order to establish a risk: benefit ratio, especially in those patients with low endothelial density or any endothelial anomaly.
Asunto(s)
Amantadina/efectos adversos , Antiparkinsonianos/efectos adversos , Edema Corneal/inducido químicamente , Opacidad de la Córnea/inducido químicamente , Enfermedad de Parkinson/tratamiento farmacológico , Aciclovir/uso terapéutico , Amantadina/farmacocinética , Amantadina/uso terapéutico , Antiparkinsonianos/farmacocinética , Antiparkinsonianos/uso terapéutico , Humor Acuoso/metabolismo , Extracción de Catarata , Ceftazidima/uso terapéutico , Edema Corneal/tratamiento farmacológico , Pérdida de Celulas Endoteliales de la Córnea/inducido químicamente , Errores Diagnósticos , Femenino , Humanos , Queratitis/diagnóstico , Persona de Mediana Edad , Complicaciones Posoperatorias/inducido químicamente , Prednisolona/uso terapéutico , Solución Salina Hipertónica/uso terapéutico , Vancomicina/uso terapéuticoRESUMEN
STUDY OBJECTIVE: To determine the utilization and cost of autologous blood that was donated preoperatively, and to compare it to the cost of employing intraoperative hemodilution to provide autologous blood for patients undergoing surgical procedures with a low risk for the need for transfusion. DESIGN: Retrospective chart review. SETTING: University medical center. PATIENTS: All ASA physical status I and II patients who underwent nononcologic gynecologic procedures and preoperatively donated autologous blood between July 1993 and June 1994. MEASUREMENTS AND MAIN RESULTS: The utilization and overall cost of predonated autologous blood was determined. The cost for employing intraoperative hemodilution and potential cost saving was then calculated. Of the 234 units of preoperatively donated autologous blood, 38 units were returned to patients who had an estimated blood loss of at least 500 ml, 32 units returned to patients who had an estimated blood loss less than 500 ml, and 164 units were wasted. No patient received allogeneic blood. The estimated total cost for all preoperatively donated autologous blood was $23,274.62. Employing hemodilution for those same patients would have cost $5,574.74, and resulted in a potential 75.6% savings. CONCLUSIONS: Inappropriate selection of patients for preoperative blood donation is costly. For those patients scheduled to undergo surgical procedures associated with a low probability for the need for blood transfusion, but who desire that autologous blood be available, hemodilution provides fresh whole blood, free from the possibility of processing or clerical errors, while decreasing blood bank utilization and affording substantial cost savings.