scholarly journals Topical Ophthalmic Cyclosporine in the Treatment of Toxic Epidermal Necrolysis

2011 ◽  
Vol 2011 ◽  
pp. 1-3
Author(s):  
Zafer Onaran ◽  
Gülşah Usta ◽  
Mukadder Koçak ◽  
Kemal Örnek ◽  
Ünase Büyükkoçak
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Toxic Epidermal Necrolysis ◽  
Ocular Surface ◽  
Acute Stage ◽  
Ocular Involvement ◽  
Pathologic Finding ◽  
Ocular Complication ◽  
Case Presentation ◽  
Intravenous Corticosteroid

Aim. To describe a case of toxic epidermal necrolysis (TEN) with ocular involvement treated with topical ophthalmic cyclosporine.Case Presentation. A 20-year-old woman developed TEN following administration of carbamazepine that was prescribed for epilepsy. Ophthalmic examination revealed bilateral pseudomembranous conjunctivitis. She was hospitalized in the intensive care unit and treated with intravenous corticosteroid and immunoglobulin. Topical cyclosporine was used in combination with topical corticosteroids for ocular surface disease. Following two months of ocular treatment, she recovered without any severe ocular complication. Ocular examination at the four-month followup showed a 2 mm of symblepharon in the lower fornix as the sole pathologic finding.Conclusion. Topical ophthalmic cyclosporine may contribute to decrease the ophthalmic complications of TEN and should be considered in the acute stage of the disease.

Comparing Vitamin A and Moist Chamber in Preventing Ocular Surface Disorders

2017 ◽  
Vol 27 (6) ◽  
pp. 714-729 ◽  
Author(s):  
Hassan Babamohamadi ◽  
Monir Nobahar ◽  
Jalaladin Razi ◽  
Raheb Ghorbani
Keyword(s):  
Clinical Trial ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Vitamin A ◽  
Ocular Surface ◽  
Slight Reduction ◽  
Moist Chamber ◽  
Icu Patients ◽  
Schirmer’S Test

The present study was conducted to determine the effectiveness of vitamin A eye ointment (VAEO) and moist chamber (MC) in preventing ocular surface disorders (OSD) in intensive care unit (ICU) patients. A total of 38 eligible patients were selected for participation in the present clinical trial. All the patients were randomly administered VAEO in one eye every 6 hr for 5 days and had a polyethylene cover (PC) placed on their other eye to create an MC that was replaced every 12 hr as well. The results of Schirmer’s test also increased by 2.06 mm in the VAEO group ( p < .001), while they showed a slight reduction by 0.15 mm in the MC group ( p = .669). VAEO was more effective in preventing OSD in ICU patients than MC and is, therefore, recommended to be used as a method of preventing OSD.

scholarly journals Case Report of an Injectional Anthrax in France, 2012

2020 ◽  
Vol 8 (7) ◽  
pp. 985
Author(s):  
Jean-Marc Thouret ◽  
Olivier Rogeaux ◽  
Emmanuel Beaudouin ◽  
Marion Levast ◽  
Vincent Ramisse ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Phylogenetic Analysis ◽  
Intensive Care ◽  
Bacillus Anthracis ◽  
Drug Users ◽  
Intravenous Drug Users ◽  
Drug Resistant ◽  
Positive Bacterium ◽  
Case Presentation ◽  
The Right

(1) Background: Bacillus anthracis is a spore-forming, Gram-positive bacterium causing anthrax, a zoonosis affecting mainly livestock. When occasionally infecting humans, B. anthracis provokes three different clinical forms: cutaneous, digestive and inhalational anthrax. More recently, an injectional anthrax form has been described in intravenous drug users. (2) Case presentation: We report here the clinical and microbiological features, as well as the strain phylogenetic analysis, of the only injectional anthrax case observed in France so far. A 27-year-old patient presented a massive dermohypodermatitis with an extensive edema of the right arm, and the development of drug-resistant shocks. After three weeks in an intensive care unit, the patient recovered, but the microbiological identification of B. anthracis was achieved after a long delay. (3) Conclusions: Anthrax diagnostic may be difficult clinically and microbiologically. The phylogenetic analysis of the Bacillus anthracis strain PF1 confirmed its relatedness to the injectional anthrax European outbreak group-II.

Management of Methomyl Poisoning

1990 ◽  
Vol 9 (4) ◽  
pp. 251-254 ◽  
Author(s):  
J. Martinez-Chuecos ◽  
F. Molinero-Somolinos ◽  
J. Solé-Violàn ◽  
R. Rubio-Sanz
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Total Dose ◽  
Activated Charcoal ◽  
Cholinesterase Activity ◽  
Gastric Lavage ◽  
Plasma Cholinesterase ◽  
Acute Stage ◽  
Plasma Cholinesterase Activity ◽  
Small Doses

Eleven patients who suffered methomyl poisoning were admitted to the intensive care unit. All of them showed cholinergic symptoms similar to that produced by organophosphate insecticides but of lesser intensity. Plasma cholinesterase activity was normal in four patients and moderately lower in the remainder (always above 32%). All of the patients showed miosis and none presented with bradycardia. No complications were detected in the acute stage or on further examination a month later. The treatment applied was: (1) gastric lavage or washing the skin; (2) the administration of activated charcoal; (3) small doses of atropine according to symptoms (average of total dose 4.3 mg). All of the patients recovered within 24-48 h. In conclusion, we can assume that methomyl poisoning does not produce serious complications if moderate surveillance is assumed. Only small doses of atropine are required to counteract symptoms.

scholarly journals Pathogenesis of Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis With Severe Ocular Complications

2021 ◽  
Vol 8 ◽  
Author(s):  
Mayumi Ueta
Keyword(s):  
Toxic Epidermal Necrolysis ◽  
Ocular Surface ◽  
Acute Stage ◽  
Stevens Johnson Syndrome ◽  
Prostaglandin E ◽  
Ocular Complications ◽  
Chronic Stage ◽  
Snp Association ◽  
Johnson Syndrome ◽  
Burn Units

Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN) is an acute inflammatory vesiculobullous reaction of the mucosa of the ocular surface, oral cavity, and genitals, and of the skin. Severe ocular complications (SOC) are observed in about half of SJS/TEN patients diagnosed by dermatologists and in burn units. Ophthalmologists treat SOC, and they tend to encounter the patients not only in the acute stage, but also in the chronic stage. Our investigation of the pathogenesis of SJS/TEN with SOC led us to suspect that abnormal innate mucosal immunity contributes to the ocular surface inflammation seen in SJS/TEN with SOC. We confirmed that cold medicines such as NSAIDs and multi-ingredient cold medications are the main causative drugs for SJS/TEN with SOC. Single nucleotide polymorphism (SNP) association analysis of cold medicine-related SJS/TEN with SOC showed that the Toll-like receptor 3 (TLR3)-, the prostaglandin-E receptor 3 (PTGER3)-, and the IKZF1 gene were significantly associated with SNPs and that these genes could regulate mucocutaneous inflammation including that of the ocular surface. We also examined the tear cytokines of SJS/TEN with SOC in the chronic stage and found that IL-8, IL-6, IFN-γ, RANTES, eotaxin, and MIP-1β were significantly upregulated in SJS/TEN with SOC in the chronic stage. Only IP-10 was significantly downregulated in SJS/TEN with SOC in the chronic stage. This mini-review summarizes the pathological mechanisms that we identified as underlying the development of SJS/TEN with SOC.

scholarly journals Extravasation Injuries, Pressure Ulcers and Ocular Surface Disorders in a Tertiary Paediatric Intensive Care Unit in South India

2020 ◽  
Vol 39 (1) ◽  
pp. 29-34
Author(s):  
Puja Amatya ◽  
Kalaimaran Sadasivam
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Ocular Surface ◽  
Paediatric Intensive Care Unit ◽  
South India ◽  
Pressure Ulcers ◽  
Critically Ill Children ◽  
Intervention Period ◽  
Post Intervention ◽  
Common Problems

Introduction: Extravasation injuries, pressure ulcers (PU), and ocular surface disorders (OSD) like exposure keratitis are common problems that we encounter in critically ill children admitted in Paediatric Intensive Care unit (PICU). There is sparse data regarding these injuries due to under reporting by staffs in intensive care unit. The primary aim of this study was to know the prevalence of extravasation injuries, ocular surface disorders and pressure ulcers in tertiary intensive care unit of south India. The secondary objective of this study was to re-evaluate the prevalence of these injuries after interventions.  Methods: During pre-intervention period, number of children with extravasation injuries, pressure ulcers and ocular surface disorders were identified. The qualitative improvement practices was implemented to decrease the prevalence of these injuries. This was followed by re-evaluation of these injuries during post-intervention period. Results: During pre-intervention period the overall prevalence of these injuries was 36/273 (13.2%). The prevalence of extravasation injuries, pressure ulcers and ocular surface disorders was 16/273 (5.9%), 12/273 (4.4%) and 8/273 (2.9%) respectively. The qualitative improvement practices were implemented in intensive care unit. During post-intervention period, the prevalence of these injuries was reduced to 10/157 (6.4%). The extravasation injuries reduced to 4/157 (2.5%), PUs to 4/157 (2.5%) and OSD to 2/157 (1.3%). Conclusions: The extravasation injuries, PUs and OSD are common problems in critically ill children. The qualitative improvement practices should be implemented and reinforced in intensive care units to prevent these injuries.

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