scholarly journals CLINICAL CHARACTERISTICS AND MANAGEMENT OF OCULAR TOXOPLASMOSIS

2019 ◽  
Vol 2 (2) ◽  
Author(s):  
Ovi Sofia ◽  
Rizqi Wahyu Hariyono
Keyword(s):  
Medical Records ◽  
Clinical Characteristics ◽  
Visual Outcome ◽  
Posterior Uveitis ◽  
Ocular Toxoplasmosis ◽  
High Seroprevalence ◽  
Tertiary Referral Hospital ◽  
Blurred Vision ◽  
Outcome Type

Introduction: Ocular toxoplasmosis is a major cause of infectious posterior uveitis worldwide. There was no exact number of ocular toxoplasmosis prevalence in Indonesia, but Indonesia was considered to have high seroprevalence in Southeast Asian. This study is conducted to determine clinical characteristics and management of ocular toxoplasmosis at outpatient clinic of Dr. Saiful Anwar General Hospital, a tertiary referral hospital in Malang, East Java. Methods : This was retrospective study. We reviewed the medical records of patients with ocular toxoplasmosis and collected the data associated with age, sex, laterality, visual outcome, type of lesions, serum serological titers, therapeutic regimens, and complications. Result : There were 48 eyes from 38 patients included in this study, mostly were female (66%) with mean age was 33,5 years. Unilateral infection (71%) was more frequent than bilateral cases (39%). Active lesions were found more than cicatrical lesions (56,25%). Most patients with active diseases had unilateral lesion (87,5%). The most common presenting complain was blurred vision (73%). Most of lesions (22 eyes; 81,4%) were located on macular region. All of patients have positive IgG antitoxoplasma serum. There were 22 patients received oral Trimethoprim-Sulfamethoxazole and steroid. Visual acuity improved in 6 patients at the end of follow-up period. Complications of retinal detachment and choroidal neovascularization were found in 3 patients. Conclusion : Active ocular toxoplasmosis is more likely to be unilateral infection with main presenting complain is  blurred vision. Most of our patients show good responses to oral trimethoprim-sulfamethoxazole and steroid.

scholarly journals Clinical Characteristics of Intermittent Esotropia

2021 ◽  
Vol 62 (12) ◽  
pp. 1650-1656
Author(s):  
Young Chae Yoon ◽  
Nam Yeo Kang
Keyword(s):  
Medical Records ◽  
Clinical Characteristics ◽  
Age At Onset ◽  
Clinical Findings ◽  
Main Symptom ◽  
Angle Of Deviation ◽  
The Mean ◽  
Onset Angle ◽  
Dissociated Vertical Deviation

Purpose: To evaluate clinical findings and surgical outcomes of intermittent esotropia.Methods: We retrospectively reviewed the medical records of 23 patients (aged 9-42 years) who presented with intermittent esotropia between January 2007 and December 2020. We analyzed the age at onset, angle of deviation, presence of symptomatic diplopia, fusional state, near stereoacuity, and surgical results.Results: The mean age at onset was 19.9 ± 8.0 years and mean duration of esodeviation was 23.4 ± 27.1 months. Mean follow-up time was 13.0 ± 15.6 months. All patients except three had symptomatic diplopia, and 78.3% showed intermittent diplopia. Mean angles of deviation were 21.6 ± 10.3 prism diopters (PD) at distance and 20.2 ± 10.4 PD at near. Twenty-one patients (91.3%) were myopia. No patients had amblyopia and one had dissociated vertical deviation. On Worth’s four-dot test, five patients (21.7%) showed diplopia and four showed suppression at both distance and near. The other patients showed fusion at near or distance. Eleven patients underwent surgical correction. At the final examination, all patients achieved successful motor alignment and fusion with resolution of diplopia. Only two patients (18.2%) achieved normal 60 arcsec stereopsis, and six attained subnormal stereopsis.Conclusions: The main symptom of intermittent esotropia was diplopia. Surgical treatment was effective in achieving good postoperative motor alignment and fusion. However, successful motor alignment did not guarantee recovery of fine stereopsis.

scholarly journals Clinical characteristics of progressive nonarteritic anterior ischemic optic neuropathy

2021 ◽  
Vol 14 (4) ◽  
pp. 517-522
Author(s):  
Omer Y. Bialer ◽  
Keyword(s):  
Risk Factors ◽  
Visual Acuity ◽  
Color Vision ◽  
Symptom Onset ◽  
Systemic Risk ◽  
Clinical Characteristics ◽  
Visual Outcome ◽  
Ischemic Optic Neuropathy ◽  
Systemic Risk Factors

AIM: To study whether patients with progressive nonarteritic anterior ischemic optic neuropathy (NAION) present earlier than patients with stable NAION and to describe their clinical characteristics and visual outcome. METHODS: This was a retrospective chart review. All patients with NAION seen during the acute stage from January 2012 to December 2018 were reviewed. Patients were included if they had documented disc edema and follow up of at least 3mo. Patients with progressive NAION were identified if they worsened in 2 out of 3 parameters: visual acuity ≥3 Snellen lines; Color vision ≥4 Ishihara plates; the visual field defect involved a new quadrant. The clinical characteristics, time from symptom onset to presentation, systemic risk factors and visual outcome were compared to patients with stable NAION. RESULTS: Totally 122 NAION cases met the inclusion criteria. Mean age was 58.1y (range 22-74), 70% were men. Twenty cases (16.4%) had progressive NAION. Patients with progressive NAION did not differ from stable NAION in their demographics, systemic risk factors or in their initial visual deficit. At last follow up, median visual acuity was 1.0 logMAR (IQR 0.64-1.55) in patients with progressive NAION, vs 0.18 (IQR 0.1-0.63) in stable NAION (P<0.001). Median color vision testing was 0 plates correct (IQR 0-2.5%) vs 92% plates correct (IQR 50%-100%) in the stable NAION group (P<0.001). Patients with progressive NAION differed in the time from symptom onset to presentation (median 2d vs 5d, P=0.011). CONCLUSION: We find no identifiable risk factors associated with progressive NAION. Progressors arrive earlier for ophthalmological evaluation.

scholarly journals Clinical characteristics of patients with subacute thyroidits and factors affecting development hypothyroidism after subacute thyroiditis

2022 ◽  
Author(s):  
İNAN ANAFOROĞLU ◽  
Murat Topbas
Keyword(s):  
Neck Pain ◽  
Medical Records ◽  
Clinical Characteristics ◽  
Subacute Thyroiditis ◽  
Upper Respiratory Tract ◽  
Inclusion Criteria ◽  
Imaging Studies ◽  
Factors Affecting ◽  
Upper Respiratory

IntroductionSubacute thyroiditis (SAT) is typically a self-limiting, inflammatory disease. Patients can experience hypothyroidism during or after an episode. We examined the clinical characteristics based on laboratory and imaging studies in patients with SAT and possible factors contributing to the development of permanent hypothyroidism after SAT.Material and methodsWe retrospectively examined medical records of patients diagnosed with SAT at one medical facility in Turkey. Patients known to have previous thyroid disease, those with <6 months of follow-up after resolution of SAT, and those who lacked sufficient data for analysis were excluded. Of the 283 patients identified 119 met all inclusion criteria. We extracted data on demographics, laboratory tests, neck pain and other symptoms, ultrasonography findings, medication use, and SAT recurrence. We examined the relationships between these variables and development of permanent hypothyroidism.ResultsThe patients were 42 years old on average, and 78% were women. Most patients (70%) described flu-like symptoms before neck pain started; accordingly, 57% had initially visited a specialty other than endocrinology before SAT was diagnosed, and 28% had received antibiotics for misdiagnosed upper respiratory tract infection. In all, 10 patients (8.4%) developed permanent hypothyroidism after SAT. These patients had received steroids significantly longer than did those without permanent hypothyroidism (mean 17.7 vs. 8.9 weeks; P = .021). Development of hypothyroidism was significantly lower among patients with thyrotoxicosis.ConclusionsThe diagnosis of SAT can be challenging. Patients who require longer-term steroids after SAT and who have recurrent SAT should be closely monitored for development of hypothyroidism.

scholarly journals Long-Term Outcomes of Behçet’s Syndrome-Related Uveitis: A Monocentric Italian Experience

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Jurgen Sota ◽  
Luca Cantarini ◽  
Antonio Vitale ◽  
Arianna Sgheri ◽  
Stefano Gentileschi ◽  
...  
Keyword(s):  
Retinal Vasculitis ◽  
Human Leukocyte ◽  
Retrospective Chart Review ◽  
Treatment Decision ◽  
Visual Outcome ◽  
Posterior Uveitis ◽  
Epiretinal Membranes ◽  
Visual Prognosis

Objectives. To examine demographic and clinical characteristics and long-term visual outcome in a cohort of Italian patients affected by Behçet’s uveitis (BU). Materials and Methods. Retrospective chart review of 47 patients with BU attending our unit between January 2018 and December 2019. Ophthalmologic manifestations, best-corrected visual acuity (BCVA), fluoroangiography and optical coherence tomography findings, and ocular complications were recorded. Predictive factors of a poor visual outcome and long-term complications were also investigated. Results. Forty-seven patients (23 males and 24 females) for a total of 84 eyes were enrolled. Uveitis was bilateral in 37 (78.7%) patients with panuveitis being the most frequent anatomical pattern (40 out of 84 eyes), whereas 27 eyes presented a posterior uveitis. Isolated anterior uveitis was detected in 16 eyes. A significant improvement of median BCVA between baseline and last follow-up values was detected (p=0.042). A higher risk of poor visual prognosis was observed in patients with uveitis duration greater than 15 years (p=0.019). A significant resolution of retinal vasculitis was detected between baseline and last follow-up evaluation (p<0.0001) whereas the mean±SD macular thickness did not decrease significantly between baseline (376.00±97.45 μm) and last follow-up evaluation (338.08±55.81 μm). Forty-two eyes developed 57 complications during the disease course. Cataract was the most frequent (n=12), followed by epiretinal membranes (n=11) and cystoid macular edema (n=6). The following variables were identified as predictors of long-term complications: human leukocyte antigen- (HLA-) B51 (p=0.006), panuveitis (p=0.037), and a uveitis duration of more than 15 years (p=0.049). Conclusions. In Italian patients, BU typically arises in the third decade and predominantly manifests as a bilateral posterior uveitis or panuveitis. Its duration is associated with a poor visual prognosis. Uveitis duration, the presence of HLA-B51, and panuveitis are predictors of long-term structural complications, thus representing main drivers in the treatment decision-making.

scholarly journals Prevalence and clinical characteristics of phenobarbitone-associated adverse effects in epileptic cats

2020 ◽  
pp. 1098612X2092492
Author(s):  
Oliver Marsh ◽  
Giulia Corsini ◽  
Jan Van Dijk ◽  
Rodrigo Gutierrez-Quintana ◽  
Luisa De Risio
Keyword(s):  
Adverse Effect ◽  
Adverse Effects ◽  
Medical Records ◽  
Clinical Characteristics ◽  
Idiopathic Epilepsy ◽  
Severe Neutropenia ◽  
Inclusion Criteria ◽  
Study Objective ◽  
Structural Epilepsy

Objectives The study objective was to investigate the prevalence and clinical characteristics of phenobarbitone-associated adverse effects in epileptic cats. Methods The medical records of two veterinary referral clinics from 2007 to 2017 were searched for cats fulfilling the inclusion criteria of a diagnosis of epilepsy, treatment with phenobarbitone and available follow-up information on the occurrence of adverse effects. Follow-up information was obtained from the medical records of the primary veterinarian and referral institutions and a questionnaire completed by the cats’ owners. Results Seventy-seven cats met the inclusion criteria. Fifty-eight were affected by idiopathic epilepsy and 19 by structural epilepsy. One or more of the following adverse effects were reported in 47% of the cats: sedation (89%); ataxia (53%); polyphagia (22%); polydipsia (6%); polyuria (6%); and anorexia (6%). Logistic regression analyses revealed significant associations between adverse effect occurrence and both phenobarbitone starting dosage and administration of a second antiepileptic drug (AED). For each 1 mg/kg q12h increment of phenobarbitone, the likelihood of adverse effects increased 3.1 times. When a second AED was used, the likelihood of adverse effects increased 3.2 times. No association was identified between epilepsy aetiology and adverse effect occurrence. An idiosyncratic adverse effect, characterised by severe neutropenia and granulocytic hypoplasia, was diagnosed in one cat. This resolved following phenobarbitone discontinuation. Conclusions and relevance The prevalence of phenobarbitone-associated adverse effects was 47%. Sedation and ataxia were most common. These are type A adverse effects and are predictable from phenobarbitone’s known pharmacological properties. In the majority of cases, adverse effects occurred within the first month of treatment and were transient. Idiosyncratic (type B) adverse effects, which were not anticipated given the known properties of the drug, occurred in one cat. Increased phenobarbitone starting dosage and the addition of a second AED were significantly associated with the occurrence of adverse effects.

scholarly journals Surgical Outcomes of Clitoroplasty in Children with Congenital Adrenal Hyperplasia and Clitoral Hypertrophy: A 19-Year Experience of a Single Surgeon

2021 ◽  
Vol 18 (21) ◽  
pp. 11152
Author(s):  
Jaebeom Jun ◽  
Sang Hoon Song ◽  
Sungchan Park ◽  
Jae Hyeon Han ◽  
Kun Suk Kim
Keyword(s):  
Congenital Adrenal Hyperplasia ◽  
Surgical Outcomes ◽  
Medical Records ◽  
Perioperative Complications ◽  
Surgical Techniques ◽  
Operation Time ◽  
Adrenal Hyperplasia ◽  
Tertiary Referral Hospital ◽  
The Mean

This study aimed to describe the experience with clitoroplasty for clitoral hypertrophy in patients with congenital adrenal hyperplasia of a single surgeon. The medical records of female pediatric patients with congenital adrenal hyperplasia who underwent clitoroplasty at a tertiary referral hospital between 2002 and 2020 were retrospectively analyzed. Three different surgical techniques were applied for clitoroplasty: recession without reduction, reduction and recession, and girth reduction and recession. A total of 104 patients underwent clitoroplasty for clitoral hypertrophy. The median patient age at the time of surgery was 10 months (range, 4 months to 10 years). The operation time was longer in reduction clitoroplasty than in recession clitoroplasty without reduction (median, 153 vs. 111 min, p = 0.003). The mean postoperative pain score of the patients did not differ among the different clitoroplasty techniques. During the mean follow-up of 37.7 months, nine (8.6%) patients underwent reperformed clitoroplasty. The rate of reperformed operation was significantly higher in patients who underwent reduction clitoroplasty (17.3%) than in those who underwent recession without reduction (2%) or girth reduction and recession (0%) (p = 0.031). Early clitoroplasty in patients with congenital adrenal hyperplasia yielded good mid-term surgical outcomes in terms of cosmesis and recurrence rate, with minimal perioperative complications.

scholarly journals Intramedullary tumors in children: analysis of 24 operated cases

2010 ◽  
Vol 68 (3) ◽  
pp. 396-399 ◽  
Author(s):  
Ricardo de Amoreira Gepp ◽  
Jose Mauro Cardoso Couto ◽  
Maria Dorvalina da Silva ◽  
Régis Tavares da Silva ◽  
Eidmar Augusto Neri
Keyword(s):  
Medical Records ◽  
Function Method ◽  
Clinical Characteristics ◽  
Neurological Function ◽  
Common Type ◽  
Male Gender ◽  
Total Resection ◽  
Intramedullary Tumors ◽  
Significant Difference

Intramedullary tumors are rare. The authors reviewed 24 cases operated between 1996 and 2006. The study assessed the clinical characteristics and surgical results based upon the neurological function. METHOD: Medical records of patients with intramedullary astrocytoma and ependymoma were reviewed. The minimal follow up time was 6 months and, at the end of this period, a comparative analysis of the neurological function was performed based using the McCormick scale score. RESULTS: Most patients had astrocytoma (75%). Male gender was more prevalent (58.3%). The most common type of tumor was graded as I or II, and in three cases these were malignant. The total resection of the tumor was achieved in 20.8% of the cases. The statistical analysis did not show a statistically significant difference between preoperative and postoperative grades at McCormick scale. CONCLUSION: The authors concluded that microsurgery to intramedullary tumors did not significantly alter the neurological function after six months.

scholarly journals Clinical Features and Management of Oral Nonodontogenic Masses in Children

2020 ◽  
Author(s):  
Hao Zhang ◽  
Qiongqiong Zhou ◽  
Weimin Shen
Keyword(s):  
Clinical Features ◽  
Medical Records ◽  
Pediatric Surgery ◽  
Inflammatory Myofibroblastic Tumor ◽  
Clinical Characteristics ◽  
The Other ◽  
Common Location ◽  
Oral Tumors ◽  
Medical University

Abstract Background: There are numerous clinical reports of oral tumors in children. However, the clinical features and management of oral nonodontogenic masses in children were rare reported. The aim of this article is to present a large series of oral nonodontogenic masses in children, analyzing the clinical characteristics of such masses and reviewing the relevant procedures for treatment.Methods: We conducted an observational retrospective study, reviewing medical records of 171 patients who were treated for oral nonodontogenic masses between 2014 and 2019 at the Department of Pediatric Surgery, Children’s Hospital of Nanjing Medical University. Data collected included age, gender, site, pathologic diagnosis and treatment strategy.Results: All patients were hospitalized in our department. Of the 171 cases, all of them were benign, however, only 1 case diagnosed as inflammatory myofibroblastic tumor showed a malignant process. The most frequent type was hemangioma (63.7%), followed by lymphangioma (16.4%), ranula (7.6%). The most common location of oral masses in the buccal mucosa. The second common location was in tongue. 16 cases of hemangioma were located in two or more sites in cavity. And 29 patients (26.6%) of hemangioma and 11 patients (39.3%) lymphangioma of were found other extraoral lesions. With regard to some cases of hemangioma, the other patients commonly undergone surgical resections or sclerotherapy. The follow-up period ranged from 1 to 5 years. The recurrence rate of hemangioma and lymphangioma were 8.3%, 17.9%, respectively.Conclusion: Most of oral nonodontogenic masses are benign, few oral masses are malignant or mimic a malignant process. Surgical resections are the most common treatment with excellent success.

scholarly journals Candidemia with Ocular Manifestrations: A Review of 26 Cases in a University Hospital in Japan

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S88-S88
Author(s):  
Tohru Takata ◽  
Yoshinobu Yoshimura ◽  
Yumiko Obata ◽  
Atsushi Togawa ◽  
Yasushi Takamatsu
Keyword(s):  
Medical Records ◽  
Major Complication ◽  
Visual Outcome ◽  
University Hospital ◽  
Ocular Involvement ◽  
Central Venous ◽  
Ocular Manifestations ◽  
Incidence Risk ◽  
Eye Involvement

Abstract Background Ocular candidiasis is a major complication of candidemia; however, many remains unknown for the incidence, risk factors, and outcome of eye involvement. Methods We retrospectively reviewed the medical records and obtained information related to fungal infection and its management, and visual outcome at Fukuoka University Hospital from 2000 to 2016. Results Of 143 patients with candidemia for whom an ophthalmology consult was requested, 26 had findings consistent with the diagnosis of ocular candidiasis. Patients with ocular candidiasis were mostly infected with Candida albicans (n = 20), followed by C. glabrata (n = 4), and C. tropicalis (n = 2). In contrast, only one patient infected with C. parapsilosis had ocular involvement although the number of the patients with C. parapsilosis candidemia was second the most among candidemia. No difference was seen for the β-d-glucan in patients with or without ocular candidiasis (128.6 vs. 106.1, P = 0.654). All of the isolates other than C. glabrata were susceptible to fluconazole. In all of 23 patients with existing central venous cathers, CVCs were removed after the diagnosis of candidemia. Four-week mortality rate in patients with ocular candidiasis was 16.7% (three of 18 patients) which was not significantly different from that in patients without ocular manifestations. All treated patients were confirmed for clearance of candidemia, received systemic antifungals, and improved for visual outcome or remained stable, and no patients complicated visual loss without surgical treatment. Therapy with micafungin or caspofungin followed by fluconazole (12 patients) was successful in all patients. Conclusion Ocular involvement occurred in 18% of patients with candidemia, and treatment with echinocandins followed by fluconazole was successful in most cases with follow-up. Disclosures T. Takata, Taisho Toyama Pharma: Speaker’s Bureau, Speaker honorarium

scholarly journals The clinical profile of childhood optic neuritis

2001 ◽  
Vol 59 (2B) ◽  
pp. 311-317 ◽  
Author(s):  
Marco Aurélio Lana-Peixoto ◽  
Gustavo Cardoso de Andrade
Keyword(s):  
Multiple Sclerosis ◽  
Optic Neuritis ◽  
Clinical Features ◽  
Medical Records ◽  
Visual Loss ◽  
Visual Outcome ◽  
The Mean ◽  
Group 2 ◽  
Group 1

PURPOSE: To report the clinical features and outcome of a series of children with optic neuritis. METHODS: We reviewed the medical records of patients up to 16 years old with optic neuritis. Group 1 comprised children seen up to two weeks after the onset of visual loss; Group 2 comprised patients already harboring optic atrophy. RESULTS: There were 15 boys and 12 girls. The mean age was 10.9 years. Bilateral optic neuritis occurred in 10. Optic disc pallor was found in 35%, edema in 46%, and 19% had normal fundus. During follow-up visual acuity improved in all but one eye in Group 1, and in six of seven eyes in children in Group 2. Just one child converted to multiple sclerosis. CONCLUSIONS: This study shows that the clinical features of childhood optic neuritis differ from those observed in adults. In children it has a better visual outcome and a lower conversion rate to multiple sclerosis than in adults.

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