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Milène Kennedy Crispin, Justin M Ko, Brittany G Craiglow, Shufeng Li, Gautam Shankar, Jennifer R Urban, James C Chen, Jane E Cerise, Ali Jabbari, Mårten C G Winge, M Peter Marinkovich, Angela M Christiano, Anthony E Oro, Brett A King
BACKGROUND: Alopecia areata (AA) is an autoimmune disease characterized by hair loss mediated by CD8(+) T cells. There are no reliably effective therapies for AA. Based on recent developments in the understanding of the pathomechanism of AA, JAK inhibitors appear to be a therapeutic option; however, their efficacy for the treatment of AA has not been systematically examined. METHODS: This was a 2-center, open-label, single-arm trial using the pan-JAK inhibitor, tofacitinib citrate, for AA with >50% scalp hair loss, alopecia totalis (AT), and alopecia universalis (AU)...
September 22, 2016: JCI Insight
Catherine A Outerbridge, Stephen D White, Verena K Affolter
OBJECTIVE: To describe a case of testicular neoplasia and alopecia universalis in a dog, and successful treatment of the latter with ciclosporin. ANIMAL: Twelve-year-old intact male wirehaired fox terrier. METHODS: Castration, skin biopsy for histopathology, lymphocyte immunophenotyping and clonality analysis of the canine T-cell receptor gamma locus (TCRγ) rearrangement. RESULTS: The dog presented with symmetrical generalized alopecia...
September 19, 2016: Veterinary Dermatology
Ana Licina, Sharan Sidhu, Jing Xie, Crispin Wan
BACKGROUND: Vitrectomy surgery is one of the commonest ophthalmic procedures performed across the world. It may be performed using general or local anaesthesia encompassing regional or topical anaesthesia depending on a number of factors, including patient suitability, and patient, surgeon or anaesthetist preference. There have so far been no evidence-based recommendations on the best form of anaesthesia for this intervention. There is no clear collated evidence base as to the best type of anaesthesia to reduce harm, and provide best surgical conditions and optimal outcome for patients...
September 19, 2016: Cochrane Database of Systematic Reviews
Kanika Singh, Sonal Sharma, Usha Rani Singh, Sambit Nath Bhattacharya
CONTEXT: Both vertical and transverse sections are used for the diagnosis of alopecia areata. However when a single biopsy is submitted the pathologist has to decide which type is better. AIMS: To compare the diagnostic histological features in vertical and transverse sections in alopecia areata scalp biopsy specimens. SETTINGS AND DESIGN: Tertiary Care Hospital. Comparative Study. MATERIALS AND METHODS: A total of 30 patients were enrolled in the study...
July 2016: International Journal of Trichology
Fábio Caetano Oliveira Leme, Eduardo Toshiyuki Moro, Alexandre Alberto Fontana Ferraz
BACKGROUND AND OBJECTIVES: Peribulbar anesthesia (PBA) has emerged as a safer option compared with intraconal retrobulbar block. Still, PBA may not be considered without risk. Numerous complications have been described when performing this technique. This report aims to describe a rare case of amaurosis and contralateral paralysis while attempting to perform a PBA. CASE REPORT: Male patient, 75-year old, physical status ASA II, undergoing cataract surgery by phacoemulsification with intraocular lens implantation...
August 20, 2016: Revista Brasileira de Anestesiologia
Siddharth Narendran, V R Saravanan, Merlyn Pereira
Purtscher and Purtscher-like retinopathy is a distinctive retinal syndrome characterized by ischemic retinal whitening in a peripapillary pattern. We report a case of Purtscher-like retinopathy in a healthy 64-year-old man after a routine peribulbar anesthetic injection for cataract surgery. Although peribulbar anesthesia is considered to be a safer alternative to retrobulbar anesthesia, it has been associated with unusual but grave complications including central retinal artery occlusion.
June 2016: Indian Journal of Ophthalmology
D Pahor, A Pahor
Purpose: To present the surgical management of perforated corneal ulcer using PRECLUDE® Pericardial Membrane, composed of expanded polytetrafluoroethylene (e-PTFE; GORE-TEX®), as an alternative surgical procedure in patients at high risk of graft rejections and to evaluate side effects for a prolonged period. Patients and Methods: The study included all patients who were admitted to our department and underwent surgical repair of perforated corneal ulcer with the e-PTFE membrane between 2010 and 2015. In total, 8 patients (8 eyes) were enrolled...
July 6, 2016: Klinische Monatsblätter Für Augenheilkunde
Tom Eke
Preoperative preparation should improve the likelihood of successful trabeculectomy surgery. The team can reconsider the appropriateness of the proposed surgery, and steps can be taken to maximize the chance of a good outcome. For example, adjustments to anti-hypertensive or anti-coagulant medications may be made, and topical ocular medications adjusted. Choice of anesthesia technique is of particular relevance to the trabeculectomy patient. Some anesthesia techniques are more likely to have serious complications, and glaucoma patients may be at higher risk of some sight-threatening complications, because the optic nerve is already damaged and vulnerable...
January 2016: Journal of Current Glaucoma Practice
Yael Shilo-Benjamini, Bruno H Pypendop, Georgina Newbold, Peter J Pascoe
OBJECTIVE: To determine plasma bupivacaine concentrations after retrobulbar or peribulbar injection of bupivacaine in cats. STUDY DESIGN: Randomized, crossover, experimental trial with a 2 week washout period. ANIMALS: Six adult healthy cats, aged 1-2 years, weighing 4.6 ± 0.7 kg. METHODS: Cats were sedated by intramuscular injection of dexmedetomidine (36-56 μg kg(-1) ) and were administered a retrobulbar injection of bupivacaine (0...
May 23, 2016: Veterinary Anaesthesia and Analgesia
Emile Calenda, Marc Muraine
No abstract text is available yet for this article.
2016: International Journal of Ophthalmology
Ogbonnaya N Iganga, Oluyemi Fasina, Charles O Bekibele, Benedictus G K Ajayi, Ayobade O Ogundipe
PURPOSE: To compare the akinetic and the analgesic effects of peribulbar and posterior sub-Tenon's anesthesia in patients undergoing cataract surgery. METHODS: In a hospital-based randomized comparative interventional study, patients aged 50 years and above who underwent elective surgery for uncomplicated cataract were randomized to receive either peribulbar block or posterior sub-Tenon block. Pain during injection, surgery, and after surgery was assessed using numerical reporting scale (NRS)...
April 2016: Middle East African Journal of Ophthalmology
A R Rajalakshmi, M Ashok Kumar
Peribulbar block, though safe, can cause serious complications such as globe perforation and peribulbar hemorrhage. Hyaluronidase is an enzyme that is used as an adjuvant in peribulbar anesthesia, and it helps in rapid penetration of the anesthetic agent. Hypersensitivity to hyaluronidase is a rare but potentially sight-threatening complication. We report a case of hyaluronidase hypersensitivity following peribulbar injection for cataract surgery mimicking as peribulbar hematoma in the immediate postinjection phase and as orbital cellulitis 48 h later...
February 2016: Indian Journal of Ophthalmology
Kyla Garft, Peter Burt, Benjamin Burt
We report a case of bilateral orbital hemorrhage as a complication of peribulbar anesthesia in a 78 year old man. Initially, unilateral orbital hemorrhage occurred but quickly spread to the contralateral side. Neuroophthalmological assessment revealed a proptosed tense globe with normal retinovascular findings. Visual acuity was adversely affected and this was conservatively managed with no lasting ophthalmic sequela. This patient's case was reported as it illustrates an unusual complication of bilateral spread of orbital hemorrhage secondary to peribulbar anesthesia...
2016: International Medical Case Reports Journal
Suman Shree Ramaswamy, B Parimala
BACKGROUND AND AIMS: Midazolam-fentanyl (MDZ:FEN) combination has been routinely used for intravenous sedation in ophthalmic surgeries. Dexmedetomidine (DEX), a recent α2 adrenoreceptor agonist indicated for sedation for ophthalmic use at a loading dose of 0.5 μg/kg over 10 min, can cause deeper plane of sedation and surgeon dissatisfaction. Therefore, we proposed to evaluate the efficacy and safety of two different loading doses of DEX. METHODS: In a prospective study, 60 patients aged 50-70 years, scheduled for retinal surgery under peribulbar block were divided equally to receive either MDZ:FEN or DEX 0...
February 2016: Indian Journal of Anaesthesia
R Sinha, A Sharma, B R Ray, R Chandiran, C Chandralekha, R Sinha
BACKGROUND: Magnesium sulphate has been used along with local anesthetics in different regional blocks and found to be effective in decreasing the time of onset of the block and increasing the duration of the block. OBJECTIVE: To evaluate the effect of addition of magnesium sulfate to standard local anesthetics mixture on the time for onset of the globe and lid akinesia for peribulbar block in ophthalmic surgeries. MATERIALS AND METHODS: Sixty patients with American Society of Anesthesiologists status I to III undergoing ophthalmic surgery under peribulbar block were included in this study...
January 2016: Saudi Journal of Anaesthesia
A M Abdelhamid, Aaa Mahmoud, M M Abdelhaq, H M Yasin, Asm Bayoumi
BACKGROUND: No studies compared parenteral dexmedetomidine with its use as an adjuvant to ophthalmic block. We compared between adding dexmedetomidine to bupivacaine in peribulbar block and intravenous (IV) dexmedetomidine during peribulbar block for cataract surgery. MATERIALS AND METHODS: A prospective, randomized, double-blind study on 90 patients for cataract surgery under peribulbar anesthesia. Study included three groups; all patients received 10 ml of peribulbar anesthesia and IV infusion of drugs as follows: Group I: Received a mixture of bupivacaine 0...
January 2016: Saudi Journal of Anaesthesia
Rupa Radhakrishnan, Rebecca Cornelius, Mary Beth Cunnane, Karl Golnik, Humberto Morales
Endophthalmitis is a sight-threatening ophthalmologic emergency. The clinical diagnosis is often challenging, and delayed diagnosis may exacerbate the poor visual prognosis. B-scan ultrasonography or spectral domain optical coherence tomography are imaging aids at the clinician's office. Cross-sectional imaging such as CT and particularly MRI can also help in the assessment of disease extent or complications. MR imaging findings are rarely described in the literature. Here, we discuss the spectrum of imaging findings of endophthalmitis and correlate them with key anatomic and pathophysiologic details of the globe...
April 2016: Neuroradiology Journal
Athanassios Kolivras, Curtis Thompson
BACKGROUND: Distinguishing between diffuse subacute alopecia areata (AA), in which the peribulbar infiltrate is absent, and pattern hair loss is challenging, particularly in cases that lack marked follicular miniaturization and a marked catagen/telogen shift. OBJECTIVE: We sought to distinguish diffuse AA from pattern hair loss using CD3(+) T lymphocytes. METHODS: A total of 28 cases of subacute AA and 31 cases of pattern hair loss were selected and a 4-mm punch biopsy was performed...
May 2016: Journal of the American Academy of Dermatology
Medhat M Messeha, Abd-Elmonem Elhesy
BACKGROUND: The aim of this study was to compare orbital muscle akinesia caused by rocuronium versus hyaluronidase when mixed with the local anesthetic in single-injection peribulbar anesthesia (PBA). PATIENTS AND METHODS: Sixty patients were included in the study and subjected to cataract extraction using phacoemulsification technique with intraocular lens implantation. Group I received peribulbar block with 5 ml mixture of 30 IU/ml hyaluronidase and 2% lidocaine...
September 2015: Anesthesia, Essays and Researches
Sudarshan Khokhar, Bhagabat Nayak, Bharat Patil, Milind Devidas Changole, Gautam Sinha, Reetika Sharma, Lipika Nayak
A 17-year-old male presented with gradual painless diminution of vision since childhood. Slit lamp examination revealed both eyes having congenital cataract. Right eye lens aspiration was performed but was uneventful, and he prepared for left eye surgery after 7 days. Immediately after giving a peribulbar block, a complete akinesia, tight eyelids, and stony hard eyeball was noted. An abaxial proptosis of 7 mm was noted. Lateral canthotomy and inferior cantholysis were done and proptosis reduced to 5 mm. Bleeding time-clotting time was normal...
2015: International Medical Case Reports Journal
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