RESUMEN
PURPOSE: To describe the rare case of a patient with thyroid ophthalmopathy whose unilateral aggravated exophthalmos was caused by the development of an ipsilateral sphenoid wing en plaque meningioma. METHODS: Case report. RESULTS: The ophthalmologic examination included visual acuity assessment, anterior segment examination, funduscopy, ocular motility examination, and exophthalmometry. Magnetic resonance imaging (MRI) of the brain and orbit revealed the existence of a sphenoid meningioma. Removal of the tumor through a pterional craniotomy was performed. The histologic examination showed that it was an en plaque meningioma. There were no postoperative complications and no recurrence of the tumor was revealed 24 months after the operation. CONCLUSIONS: Detailed ophthalmologic examination and MRI of the brain and orbit are necessary in every patient with deterioration of the exophthalmos even if the suggestive cause seems obvious.
Asunto(s)
Exoftalmia/etiología , Oftalmopatía de Graves/complicaciones , Neoplasias Meníngeas/complicaciones , Meningioma/complicaciones , Encéfalo/patología , Femenino , Humanos , Imagen por Resonancia Magnética , Neoplasias Meníngeas/patología , Neoplasias Meníngeas/cirugía , Meningioma/patología , Meningioma/cirugía , Persona de Mediana Edad , Órbita/patología , Agudeza VisualRESUMEN
PURPOSE: To report a case and describe the clinical approach to a patient with a non-small cell lung carcinoma and paraneoplastic optic neuropathy. METHODS: Case report. RESULTS: A 79-year-old woman with known non-small cell lung carcinoma was admitted with a swollen optic disc in the right eye. After detailed clinical, laboratory, and imaging studies, the authors diagnosed paraneoplastic optic neuropathy, excluding other possible diagnosis. CONCLUSIONS: Paraneoplastic optic neuropathy is a clinical challenge and should be considered as a possible diagnosis in every cancer patient with optic disc edema.
Asunto(s)
Carcinoma de Pulmón de Células no Pequeñas/patología , Neoplasias Pulmonares/patología , Enfermedades del Nervio Óptico/diagnóstico , Síndromes Paraneoplásicos/diagnóstico , Anciano , Diagnóstico Diferencial , Resultado Fatal , Femenino , Angiografía con Fluoresceína , Fondo de Ojo , Humanos , Imagen por Resonancia Magnética , Agudeza VisualRESUMEN
A retrospective person-time analysis of the randomized and non-randomized extension phases of four phase III trials was performed to assess the incidence of adverse cardiovascular events in 2680 HIV-infected patients receiving indinavir or nucleoside reverse transcriptase inhibitor therapy, or both. The observed rate of cardiovascular events was not increased in patients receiving indinavir-based regimens compared with therapy without a protease inhibitor. Extrapolation of these findings is limited by the brief length of therapy and the small number of cases.
Asunto(s)
Fármacos Anti-VIH/efectos adversos , Enfermedades Cardiovasculares/etiología , Infecciones por VIH/tratamiento farmacológico , Indinavir/efectos adversos , Inhibidores de la Transcriptasa Inversa/efectos adversos , Ensayos Clínicos Fase III como Asunto , Quimioterapia Combinada , Humanos , Ensayos Clínicos Controlados Aleatorios como Asunto , Estudios Retrospectivos , Factores de RiesgoAsunto(s)
Proteínas de la Membrana Bacteriana Externa , Infecciones por Haemophilus/epidemiología , Vacunas contra Haemophilus , Haemophilus influenzae tipo b , Polisacáridos Bacterianos , Vacunación , Alaska/epidemiología , Proteínas de la Membrana Bacteriana Externa/efectos adversos , Proteínas de la Membrana Bacteriana Externa/inmunología , Portador Sano/microbiología , Preescolar , Infecciones por Haemophilus/microbiología , Vacunas contra Haemophilus/efectos adversos , Vacunas contra Haemophilus/inmunología , Haemophilus influenzae tipo b/fisiología , Humanos , Indígenas Norteamericanos , Lactante , Recién Nacido , Faringe/microbiología , Polisacáridos Bacterianos/efectos adversos , Polisacáridos Bacterianos/inmunología , Población Rural , Vacunas Conjugadas/efectos adversos , Vacunas Conjugadas/inmunologíaRESUMEN
In vaccine trials, diary questionnaires or vaccination report cards (VRCs) are used extensively to collect complaints reported by subjects or guardians following vaccination. These have not been evaluated for accuracy or standardized to facilitate tolerability comparisons among vaccines.Objectives -(1) Develop standardized, age-specific VRCs for collecting self-reported adverse events (AEs) in trials; (2) Evaluate whether complaints elicited by nurse examinations or telephone interviews were missed by VRCs.Methods -Vaccine-trial databases, focus groups, experts and experienced nurses were used to develop paediatric and adolescent/adult VRCs. VRCs were evaluated at four sites. The primary outcome was subjects with AEs missed on the VRC and reported in nurse examinations (for injection-site reactions) or telephone interviews (for systemic complaints).Results -Of 855 subjects, 96.5% completed VRCs. For systemic complaints, 1.5% (12/812) reported both no complaint on VRCs and at least one complaint in telephone interviews. For injection-site reactions, 5.1% (53/1030) of injection sites had both no reaction reported on VRCs and had reactions noted by nurse examination. No missed AEs were rated as severe.Conclusion -The data suggest VRCs provide a practical and reasonably complete method of eliciting complaints following vaccination. Copyright (c) 2000 John Wiley & Sons, Ltd.