Purpose To evaluate patients with lacrimal dysgenesis. Design Retrospective, n onrandomized, comparative case series. Participants Fifty patients with lacrimal dysgenesismanaged between 1992 and 2003. Testing/interven...Purpose To evaluate patients with lacrimal dysgenesis. Design Retrospective, n onrandomized, comparative case series. Participants Fifty patients with lacrimal dysgenesismanaged between 1992 and 2003. Testing/intervention The diagnosis of lacrimal outflow dysgenesis was made based on the following criteria: absent or hypoplastic punctum, canaliculus, lacrimal sac, and nasolacrimal duct, appearing in isolation or combination. Our management algorithmincluded observation, punc toplasty with intubation, or open lacrimal surgery, with or without intubation. Main outcome measure Success, partial success, or failure of treatment. Results Lacrimal dysgenesis in our 50 patients (23 male and 27 female) involved 83 eyes, distributed as follows: proximal in 74 eyes (89%), distal in 27 (33%), and bo th in 18 (22%). Thirty (60%) patients presented with isolated lacrimal dysgene sis, and 20 (40%) presented with a systemic syndrome or dysmorphism. Thirty th ree (66%) patients had bilateral involvement. Epiphora was the most common pres enting symptom. Eighteen (36%) patients had a positive family history. Open lac rimal surgery was performed in a total of 29 (35%) of the 83 eyes: 25 had succe ss, 3 had partial success, and 1 had failure. Conclusion Both sporadic and hered itary forms of lacrimal outflow dysgenesis may present as an isolated finding or a part of a systemic syndrome or dysmorphism, occurring usually with bilateral involvement and presenting at a younger age in the setting of systemic anomalies . Proximal and distal lacrimal outflow systems may be involved with epiphora as the most common presenting symptom. The algorithm we have presented provides a s ystematic approach to the management of lacrimal outflow dysgenesis.展开更多
Prematurity is an important cause of perinatal death, and no reliable biochemical/biophysical markers exist to identify newborns with an increased mortality risk. We aimed to use S100B concentrations in urine as an ea...Prematurity is an important cause of perinatal death, and no reliable biochemical/biophysical markers exist to identify newborns with an increased mortality risk. We aimed to use S100B concentrations in urine as an early indicator of risk of neonatal death. We did a cross- sectional study using urine obtained from 165 preterm newborns, of whom 11 suffered neonatal death within the first week, 121 displayed no overt neurologic syndrome, and 33 suffered neonatal hypoxia and intraventricular hemorrhage (IVH) but not ominous outcome. Urine S100B concentrations were determined at four time- points and corrected for gestational age by conversion to multiples of median (MoM) of healthy controls of the same gestational age. Ultrasound imaging was assessed within the first 72 h from birth. In infants that died within the first week, S100B levels in urine were already higher than controls at first urination and increased progressively between the 24 and 96- h time- points. Multiple logistic regression analysis showed a significant correlation between urine S100B protein concentrations and the occurrence of neonatal death. An S100B concentration cut- off of 12.93MoM at first urination had a sensitivity of 100% and a specificity of 97.8% for predicting an ominous outcome. The positive predictive value was 78.6% , the negative predictive value was 100% . Measurement of urine S100B protein levels in preterm newborns could be useful to identify newborns at higher risk of neonatal death.展开更多
文摘Purpose To evaluate patients with lacrimal dysgenesis. Design Retrospective, n onrandomized, comparative case series. Participants Fifty patients with lacrimal dysgenesismanaged between 1992 and 2003. Testing/intervention The diagnosis of lacrimal outflow dysgenesis was made based on the following criteria: absent or hypoplastic punctum, canaliculus, lacrimal sac, and nasolacrimal duct, appearing in isolation or combination. Our management algorithmincluded observation, punc toplasty with intubation, or open lacrimal surgery, with or without intubation. Main outcome measure Success, partial success, or failure of treatment. Results Lacrimal dysgenesis in our 50 patients (23 male and 27 female) involved 83 eyes, distributed as follows: proximal in 74 eyes (89%), distal in 27 (33%), and bo th in 18 (22%). Thirty (60%) patients presented with isolated lacrimal dysgene sis, and 20 (40%) presented with a systemic syndrome or dysmorphism. Thirty th ree (66%) patients had bilateral involvement. Epiphora was the most common pres enting symptom. Eighteen (36%) patients had a positive family history. Open lac rimal surgery was performed in a total of 29 (35%) of the 83 eyes: 25 had succe ss, 3 had partial success, and 1 had failure. Conclusion Both sporadic and hered itary forms of lacrimal outflow dysgenesis may present as an isolated finding or a part of a systemic syndrome or dysmorphism, occurring usually with bilateral involvement and presenting at a younger age in the setting of systemic anomalies . Proximal and distal lacrimal outflow systems may be involved with epiphora as the most common presenting symptom. The algorithm we have presented provides a s ystematic approach to the management of lacrimal outflow dysgenesis.
文摘Prematurity is an important cause of perinatal death, and no reliable biochemical/biophysical markers exist to identify newborns with an increased mortality risk. We aimed to use S100B concentrations in urine as an early indicator of risk of neonatal death. We did a cross- sectional study using urine obtained from 165 preterm newborns, of whom 11 suffered neonatal death within the first week, 121 displayed no overt neurologic syndrome, and 33 suffered neonatal hypoxia and intraventricular hemorrhage (IVH) but not ominous outcome. Urine S100B concentrations were determined at four time- points and corrected for gestational age by conversion to multiples of median (MoM) of healthy controls of the same gestational age. Ultrasound imaging was assessed within the first 72 h from birth. In infants that died within the first week, S100B levels in urine were already higher than controls at first urination and increased progressively between the 24 and 96- h time- points. Multiple logistic regression analysis showed a significant correlation between urine S100B protein concentrations and the occurrence of neonatal death. An S100B concentration cut- off of 12.93MoM at first urination had a sensitivity of 100% and a specificity of 97.8% for predicting an ominous outcome. The positive predictive value was 78.6% , the negative predictive value was 100% . Measurement of urine S100B protein levels in preterm newborns could be useful to identify newborns at higher risk of neonatal death.
