[Bilateral Medial Recession for Infantile Esotropia]. / Bilaterale Medialis-Rücklagerung bei frühkindlicher Esotropie.

OBJECTIVE: Bilateral medial rectus recession (BMR) is a common surgical treatment of infantile esotropia with smaller and larger deviations. The aim of this study is to evaluate the dose-effect relationship and the success of the therapy. DESIGN: The study is a retrospective, monocentric clinical study with one surgeon and 60 patients with infantile esotropia. METHODS: 60 patients with infantile esotropia were included, who were treated with BMR using microinvasive technique between April 2012 and September 2015. We evaluated pre- and post-operative data in three follow-ups, at 3, 12 and 36 months. A residual deviation ≤ ± 10 PD (prism dioptres) at 12 month follow-up or a measurable positive binocular vision was defined as a positive outcome. RESULTS: Age at surgery is 5.2 ± 4.6 (median ± SD). Pre-operative deviations at distance were 41 ± 10.5 PD and for near vision 44 ± 11 PD. Spherical equivalent refractive errors were + 2.25 dpt. Post-operative deviations at distance (n = 58) at 12 month follow-up were 6 ± 9.6 PD and at 36 month follow-up (n = 38) were 4 ± 10.5 PD. The mean reduction in deviation in 12 month follow-up were 3.08 ± 1.20 PD per mm and at 36 months 3.18 ± 1.27 PD. For children ≤ 4 years, the value was 3.93 ± 1.86 PD and for children > 4 years 2.81 ± 0.98 PD. The therapeutic success at 12 month follow-up was 67%. Positive binocular vision was proved post-operative in 62% of patients. CONCLUSION: BMR is a long-term and efficient surgical treatment of infantile esotropia. The average dose-effect relationship at 36 month follow-up was 3.1 PD per mm.

Role of macrophage migration inhibitory factor in head and neck cancer and novel therapeutic targets: A systematic review.

Macrophage migration inhibitory factor (MIF) is a proinflammatory cytokine involved in systemic, autoimmune, and inflammatory diseases, such as obesity, rheumatoid arthritis, and systemic lupus erythematosus. For the 2 past decades, MIF has been reported to participate in carcinogenesis, disease prognosis, tumor cell proliferation, invasion, and tumor-induced angiogenesis in many cancers. The purpose of this article is to review published experimental and clinical data for MIF and its involvement in upper aerodigestive tract cancers. Based on the current literature, we propose a biomolecular model describing the mechanisms underlying the involvement of MIF in the initiation, progression, apoptosis, and proliferation of head and neck tumor cells. In reference to this model, potential therapeutic approaches based on the use of MIF antagonists and neutralizing antibodies are described. It is concluded that MIF is a promising target for future therapeutic strategies, both with and without chemoradiation strategies.

Clinical characteristics of people with head nodding in southern Tanzania.

We have previously described a seizure disorder characterized by head nodding (HN). In a prospective study in southern Tanzania, we evaluated 62 patients with HN. Here, we report the patients' clinical characteristics and those of their seizures, which indicate high seizure frequency, unsatisfactory seizure control, a high burden of cognitive impairment and disease-associated barriers to education.

The role of Onchocerca volvulus in the development of epilepsy in a rural area of Tanzania.

INTRODUCTION: Several reports indicate high prevalences of both onchocerciasis and epilepsy in some regions of Africa. This raises the question of whether these diseases are associated. We therefore investigated people with epilepsy and/or onchocerciasis living in an area in Tanzania endemic for Onchocerca volvulus (O. volvulus). METHODS: We collected clinical information, skin snips, and blood from 300 individuals, and cerebrospinal fluid (CSF) from 197. Participants were allocated to 4 groups consisting of people with epilepsy and onchocerciasis (n=135), those with either epilepsy (n=61) or onchocerciasis only (n=35), and healthy individuals (n=69). Samples were evaluated for microfilaria, IgG4 antibodies against O. volvulus, O. volvulus antibody index (CSF/serum), and CSF routine parameters. Polymerase chain reaction (PCR) was performed on skin snips and CSF. RESULTS: No difference was found in microfilarial density between participants with and without epilepsy (P=0.498). The antibody index was raised in 2 participants. CSF PCR was negative in all samples tested. DISCUSSION: Our results do not give evidence of a relationship between O. volvulus and epilepsy. Despite the fact that 2 participants had raised antibody index, the existence of cerebral onchocerciasis caused by migration of microfilariae into the CSF appears unlikely. However, to date unexplored reactions to the infestation with O. volvulus causing epilepsy cannot be excluded.