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Medical Sciences	80%

Selected Abstracts

Patterns of severe abdominal wall defects: Insights into pathogenesis, delineation, and nomenclature

BIRTH DEFECTS RESEARCH, Issue 3 2007
Liliana Vauthay
Abstract BACKGROUND: During the last decade, descriptions of malformation complexes involving an abdominal wall defect (AWD) have repeatedly appeared in the literature, and there has been frequent confusion regarding nomenclature, definitions, and delineations. The aims of this work were to evaluate possible embryological relationships among AWD cases, review the related nomenclature, identify patterns involving AWDs, and stress the importance of complete clinical descriptions. METHODS Cases diagnosed as AWD complexes were selected from live- and stillborn infants of the Hospital Materno Infantil Sardá, Buenos Aires, and from the Laboratory of Perinatal Pathology, Buenos Aires, Argentina. They were sorted by the location of the AWD, the umbilical cord length, and the presence or absence of a persistent cloaca. The findings in 26 cases were described, according to proposed definitions. RESULTS: Three patterns could be identified: 1) the AWD involving the umbilical ring, a persistent or exstrophic cloaca, and a spinal cord anomaly; 2) the AWD extending laterally to the umbilical ring, severe unilateral limb defects, and same-sided agenesis of abdominal organs; and 3) the AWD not involving the umbilical ring, clefts, exencephaly, and amputations. Furthermore, overlapping among these patterns was observed, and possible involved mechanisms are discussed. CONCLUSIONS: The observed overlapping among patterns suggested that malformation complexes involving AWDs might not be independent conditions but rather belong to a common and broader spectrum of anomalies. Complete clinical descriptions, the avoidance of synonyms and generalizations, and strictly defined inclusion criteria are proposed for a better understanding of pathogenetic pathways in, and relationships among, AWD complexes. Birth Defects Research (Part A), 2007. © 2006 Wiley-Liss, Inc. [source]

4341: Are visual evoked potentials and pattern ERG useful in neuro-ophthalmology?

ACTA OPHTHALMOLOGICA, Issue 2010
GE HOLDER
Purpose To describe the roles of VEP and PERG in clinical neuroophthalmology. Methods Case based examples. Results Objective visual system testing with electrophysiology allows the distinction between optic nerve and macular dysfunction, often difficult in clinical practice. Examples will be shown of the types of VEP abnormality that can occur in different disorders of optic nerve function. PERG should also be performed in the patient with visual symptoms; if the PERG suggests macular dysfunction, full-field ERG is indicated in order to determine whether that macular dysfunction is part of a generalised retinal process or is dysfunction localised to the macula. Electrophysiology further allows the diagnosis of non-organic visual loss and the quantification of visual system dysfunction. Conclusion The objective functional assessment with electrophysiology is an important part of the diagnostic armamentarium available to neuroophthalmologists. [source]

Cutaneous larva migrans: clinical features and management of 44 cases presenting in the returning traveller

BRITISH JOURNAL OF DERMATOLOGY, Issue 3 2001
V. Blackwell
Background Cutaneous larva migrans (CLM) is the result of a nematode infection, and shows a characteristic creeping eruption. As travel to the tropics increases, many British citizens may be returning with this infection, which is often misdiagnosed or treated incorrectly. Objectives To perform a retrospective survey of 44 cases of CLM presenting to the Hospital for Tropical Diseases in London over the last 2 years. Methods Cases were reviewed with regard to patient characteristics, source of infection, source of referral, clinical features and therapy. Results Most infections were acquired in Africa (32%), the Caribbean (30%) and South-east Asia (25%), but also in Central and South America. There was a history of exposure to a beach in 95% of patients and the median duration of symptoms was 8 weeks (range 1,104). Lesions mainly affected the feet (39%), buttocks (18%) and abdomen (16%), but the lower leg, arm and face were also affected. Multiple lesions were seen in seven of 44 cases (16%). Laboratory abnormalities were absent in all patients. Of 44 patients seen, four needed no treatment, 28 were cured by a single course of treatment, 11 required a second course of therapy and one patient was treated three times. Thirty-one patients received oral albendazole 400 mg daily for 3,5 days and 24 were cured (77%). Five patients received 10% thiabendazole cream topically for 10 days and four were cured (80%). Four patients received oral thiabendazole 1·5 g daily for 3 days and all required further therapy. Conclusions In view of the range of treatment regimens recorded, a randomized controlled trial comparing topical and systemic therapies is warranted. [source]

2112: AO imaging of acute macular diseases

ACTA OPHTHALMOLOGICA, Issue 2010
M PAQUES
Purpose To show clinical cases of acute macular diseases and their follow-up by adaptive optics flood imaging. Methods Cases of acute retinal ischemia, of acute macular neuroretinopathy, of photic injury and of poppers-related retinopathy have been observed by a prototypic adaptive optics flood imaging (ImagineEye corporation). Images from follow-up examinations have been registered in order to obtain retinal monitoring at the single photoreceptor level. Iamges were compared to high resolution OCT scans. Results Precise extension and progression/regression of lesions could be documented in all cases. Acute macular neuroretinopathy showed residual cones persisting within an area devoid of any detectable cone. Minute progression and regression of lesions could be documented. Acute ischemia of the inner retina due to central retinal vein occlusion resulted in focal masking of the cone mosaic. The cone mosaic reappeared during follow-up. Photic injury showed no changes over a 1 year follow-up. Images of poppers-related retinopathy showed partial improvement over time. Conclusion Adaptive optics flood imaging allows documentation of the extension and progression of acute maculopathies of various origins. [source]

Appraisal and management of subclinical choroidal inflammation: the iceberg phenomenon

ACTA OPHTHALMOLOGICA, Issue 2009
CP HERBORT
Purpose To explore further the ocular fundal structures after funduscopy has been performed in intraocular inflammatory diseases, we have at our disposal among other investigational imaging methods, fluorescence angiography comprising fluorescein angiography (FA) and indocyanine green angiography (ICGA). In most cases dual FA & ICGA is necessary as the two methods image completely different structures. Fluorescein angiography is giving information on superficial structures including the optic disc, the retinal vessels and the retina as well as on the RPE, whereas ICGA is exploring the choroidal compartment. In contrast to FA that usually does not furnish additional information but is only giving more precise images of the superficial structures explored, ICGA is revealing elements, in case of choroidal inflammatory involvement, that no other method can show. The choroidal inflammatory lesions can be very extensive while often causing only faint or no signs during clinical examination and with other investigational imaging methods, a phenomenon which corresponds to the so-called "iceberg effect". This aptitude of ICGA to show lesions that are otherwise inaccessible make it an essential method to detect and follow choroidal lesions. Methods Cases where diagnosis cannot be made without ICGA or cases where inflammation can only be followeb by ICGA, the so-called iceberg constellation because other methods show only faint or no signs, will be presented. Conclusion Inflammatory lesions limited to the choroid cannot be detected without performing ICGA which is indispensible to diagnose purely choroidal diseae and to monitor the evolution of choroidal inflammation. [source]