Assuntos
Neovascularização de Coroide , Síndrome dos Pontos Brancos , Corioide/diagnóstico por imagem , Neovascularização de Coroide/diagnóstico , Neovascularização de Coroide/diagnóstico por imagem , Angiofluoresceinografia/métodos , Humanos , Imagem Multimodal , Estudos Retrospectivos , Tomografia de Coerência Óptica/métodosRESUMO
INTRODUCTION: Childhood ocular trauma is a preventable cause of visual impairment and blindness worldwide. The purpose of our study was to determine demographic, etiologic, and clinical characteristics, visual outcome, and factors affecting visual prognosis in children with open globe injuries (OGI) and to analyze the predictive value of ocular trauma scoring systems for OGI in children. METHODS: We conducted a retrospective study enrolling 120 pediatric patients hospitalized for OGI from January 2010 to March 2017. Age, gender, date of trauma, time between trauma and presentation, place and circumstances of injury, etiology, visual acuity (VA), wound location and type of injury based on the Birmingham Eye Trauma Terminology, and the clinical signs were recorded. We recorded the number of surgical procedures performed, complications and visual outcomes. RESULTS: The mean age was 7.38 years. In all, 62.5% of the patients were male, and 37.5% were female. The gender ratio was observed to decrease with increasing age. The mean time interval between injury and consultation was 22.80±42.68hours. Injuries usually occurred at home (80%) followed by playgrounds and sports venues (8.3%), the street (6.7%) and school (5%). All of the OGI's were accidental, and the main context was play (70%). The most common traumas were penetrating injury (60.8%) and metal (30%) objects. Penetrating trauma accounted for 68.3% of cases, followed by rupture (27.5%) and intraocular foreign body (IOFB) (7.5%). Initial VA was<1/10 in 59.2% of cases, and the point of entry was the cornea in 65.8% of cases. Final VA was<1/10 in 39.69% of all cases. FVA was significantly correlated with BCVA prior to the surgery, mechanism of the trauma, wound location and size, and other associated lesions. The Ocular Trauma Score (OTS) and the Pediatric Ocular Trauma Score (POTS) were significantly correlated with final VA. CONCLUSION: OGI's in children occurs most frequently in school-age boys. Prognosis is determined by presenting visual acuity, trauma score, and wound severity and location.
Assuntos
Ferimentos Oculares Penetrantes/diagnóstico , Ferimentos Oculares Penetrantes/epidemiologia , Adolescente , Cegueira/diagnóstico , Cegueira/epidemiologia , Cegueira/etiologia , Criança , Pré-Escolar , Corpos Estranhos no Olho/diagnóstico , Corpos Estranhos no Olho/epidemiologia , Corpos Estranhos no Olho/etiologia , Ferimentos Oculares Penetrantes/patologia , Feminino , Humanos , Lactente , Masculino , Prognóstico , Estudos Retrospectivos , Ruptura/diagnóstico , Ruptura/epidemiologia , Ruptura/etiologia , Índices de Gravidade do Trauma , Tunísia/epidemiologia , Baixa Visão/diagnóstico , Baixa Visão/epidemiologia , Baixa Visão/etiologia , Acuidade VisualAssuntos
Hemangioma Cavernoso do Sistema Nervoso Central/complicações , Hemangioma Cavernoso do Sistema Nervoso Central/diagnóstico , Doenças do Nervo Oculomotor/diagnóstico , Doenças do Nervo Oculomotor/etiologia , Diagnóstico Diferencial , Diplopia/diagnóstico , Diplopia/etiologia , Diplopia/cirurgia , Feminino , Hemangioma Cavernoso do Sistema Nervoso Central/cirurgia , Humanos , Imageamento por Ressonância Magnética , Doenças do Nervo Oculomotor/cirurgia , Adulto JovemAssuntos
Glaucoma/congênito , Glaucoma/patologia , Feminino , Humanos , Lactente , Recidiva , Remissão EspontâneaAssuntos
Anestesia Local/métodos , Extração de Catarata/métodos , Procaína/análogos & derivados , Administração Tópica , Adulto , Feminino , Humanos , Masculino , Medição da Dor , Dor Pós-Operatória/tratamento farmacológico , Satisfação do Paciente , Projetos Piloto , Procaína/administração & dosagem , Tunísia , Adulto JovemAssuntos
Carcinoma Neuroendócrino/diagnóstico , Cefaleia/diagnóstico , Oftalmoplegia/diagnóstico , Neoplasias dos Seios Paranasais/diagnóstico , Seio Esfenoidal/patologia , Idoso , Carcinoma Neuroendócrino/complicações , Diagnóstico Diferencial , Evolução Fatal , Cefaleia/etiologia , Humanos , Masculino , Oftalmoplegia/etiologia , Neoplasias dos Seios Paranasais/complicações , Seio Esfenoidal/diagnóstico por imagemRESUMO
Polymerase chain reaction (PCR) amplification of antibiotic resistance genes as well as staphylococcal cassette chromosome mec (SCCmec) typing and pulsed-field gel electrophoresis (PFGE) of SmaI macrorestriction fragments of genomic DNA were used to characterize 45 methicillin-resistant coagulase-negative staphylococci (MRCoNS) isolates responsible of bacteremia recovered in patients at the Bone Marrow Transplant Centre of Tunisia in 1998-2007. Among the 45 MRCoNS isolates, Staphylococcus epidermidis was the most prevalent species (75.6%) followed by Staphylococcus haemolyticus (22.2%) and Staphylococcus hominis (2.2%). Extended susceptibility profiles were generated for MRCoNS against 16 antimicrobial agents. Out of 45 mecA-positive strains, 43 (95.6%) were phenotypically methicillin-resistant and two (4.4%) were methicillin-susceptible. The msr(A) was the most prevalent gene (13 isolates; 48.1%) among erythromycin-resistant isolates. The erm(C) was found alone in seven (25.9%) or in combination with both erm(A) and erm(B) in two (7.4%) isolates. The aac(6')-Ie-aph(2â³)-Ia was the most prevalent gene among aminoglycoside-resistant isolates, detected alone in 14 isolates (33.3%) isolates, in combination with ant(4')-Ia in 18 (42.8%) isolates, in combination with aph(3')-IIIa in four (9.5%) or with both ant(4')-Ia and aph(3')-IIIa in two (4.7%) isolates. The ant(4')-Ia was detected in three (7.1%) isolates and the aph(3')-IIIa in one (2.4%) isolate. Among tetracycline-resistant isolates, six (85.7%) strains harbored the tet(K) gene and one (14.3%) strain carried tet(K) and tet(M) genes. SCCmec types IV (31%) and III (24.5%), the most prevalent types detected, were found to be more resistant to non-ß-lactam antibiotics. A wide diversity of isolates was observed by PFGE among MRCoNS.