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At least 253 records · Page 14Linked to original sources
PubMed1994

Evidence for genetic homogeneity of Setleis' syndrome and focal facial dermal dysplasia.

A healthy 14-month-old boy had multiple, circular, scar-like depressions on both temples, which had been present since birth. Delivery had been normal, and had not required the use of forceps or other instruments. His mother and one sister had similar, but less obvious, lesions on the temples. The three affected family members had similar facial features, with laterally deficient eyebrows, and a prominent upper lip with down-turned mouth. Additional features in the baby were sparse lower eyelashes, medial epicanthal folds, and skin dimpling on one side of the chin. Focal facial dermal dysplasia (FFDD) denotes a condition in which there are bitemporal, round, scar-like lesions. It is inherited as an autosomal dominant trait with variable penetrance and expressivity, and there are no associated features. Setleis' syndrome is recessively inherited, and is characterized by similar bitemporal defects associated with other dysmorphic features, including deficient eyelashes and a prominent upper lip. This report of dominantly inherited bitemporal dermal defects with characteristic facies supports the idea that FFDD and Setleis' syndrome are a single disorder.

Adult↗
PubMed2005

[Eyelid alterations associated with palpebral ectropion].

PURPOSE: To evaluate eyelid margin alterations in ectropion carriers. METHODS: An observational study was done involving 53 eyelid ectropion patients and 25 individuals with dermochalasis (control group). Eyelash position and margin inflammation were observed using digital images. The data were submitted to statistical analysis. RESULTS: Patients with ectropion showed a decreased number of eyelashes, loose convexity, trichiasis and distichiasis as compared with the control group. CONCLUSION: Patients with eyelid ectropion have eyelid margin alterations probably due to the chronic inflammatory process in this region.

Blepharitis↗
PubMed1999

[Blepharitis due to Demodex: myth or reality?].

PURPOSE: Demodex folliculorum has been incriminated in the development of blepharitis although much controversy persists. Certain authors suggest that Demodex is a direct pathogen in chronic palpebral conditions while others consider the saprophyte to be innocuous to skin. METHODS: We conducted a prospective study of eyelashes in 100 persons, searching for Demodex folliculorum and chronic blepharitis. Microscopy in immersion oil after storage in a moist chamber was performed. RESULTS: The incidence of Demodex folliculorum was very high in patients with blepharitis compared with normal controls. Incidence increased with age. Harmless cuffs around the base of the eyelashes was found in 4% with Demodex irradior. CONCLUSION: Demodex should be considered as the cause of chronic blepharitis. Anti-Demodex treatment is indicated when the parasite is found.

Adult↗
PubMedDate not supplied

[Eyelids infestation by Phthirus pubis in a boy].

A clinical case of Phthirus pubis infestation of the eyelids in an eight-year-old boy is presented. He complained of a bilateral eyelids inflammation for the last two weeks which had not healed with a daily application of a collyrium. Physical examination showed the presence of small dark spheres, of approximately 1 mm, attached to the proximal extreme of the eyelashes. A microscopical examination of these elements permitted to identify adults and eggs of P. pubis. Neither insects nor eggs were found in the scalp of the patient. Treatment consisted in the extraction of the parasite elements by means of a fine forceps after the application of liquid vaseline in the eyelashes. A total of 23 adult insects and 32 eggs was removed. The boy proceeded from a boarding school,--where none of the other 27 children was found infested--and stayed there from Monday to Friday, going home for week ends. It was impossible to contact the mother, the most probable source the patient infestation, for epidemiological and prophylactical purposes.

Animals↗
PubMed2002

Phthiriasis palpebrarum: an unusual blepharoconjunctivitis.

Phthiriasis palpebrarum is an unusual cause of blepharoconjunctivitis and may easily be overlooked because of the failure of physicians to recognize Phthirus pubis. We report a case of a 30-year-old woman with persistent itching in the left eyelid which was unsuccessfully treated under the diagnosis of allergic blepharoconjunctivitis. Careful ophthalmic examination revealed seven bugs with multiple red pinpoint excretions and numerous small translucent oval eggs (nits) coating the eyelashes. The patient was successfully treated with mechanical removal of all the lice and nits from the eyelashes. The specimen proved histopathologically to be the Phthirus pubis infestation. The Phthirus pubis infestation is usually associated with poor hygiene in overcrowded or undeveloped country. However, it may become a notable problem because of frequent traveling and commercial activities across the different countries.

Adult↗
PubMed1992

Experimental comparison of laser and cryosurgical cilia destruction.

We compared cryosurgery with the argon and carbon dioxide lasers in a rabbit model to evaluate the permanence of eyelash destruction as well as the gross and histologic effects on the eyelid. Each modality was equally effective in preventing eyelash regrowth. Cryosurgery and the carbon dioxide laser produced the greatest acute soft tissue swelling; the carbon dioxide laser produced the most pronounced gross eyelid alterations. The argon laser produced minimal eyelid tissue change. Long-term histologic tissue alterations were not striking and were confined to eyelids treated with cryosurgery and the carbon dioxide laser. We conclude that, of the two lasers, the argon is the best suited to the clinical treatment of trichiasis: it is widely available, more precise in limiting contiguous tissue destruction when delivered through a slit lamp, and is safer for use near the eye.

Animals↗
PubMed1986

Argon laser phototherapy of phthiriasis palpebrarum.

Argon laser phototherapy is an alternative new, quick, and effective method of treating phthiriasis palpebrarum in one sitting. A beam at a setting of 200-microns size, 0.1 second time, and 200 mW power is employed to destroy individual adult parasites and nits. The only drawbacks are an occasional but tolerable stinging and the slicing of the eyelash stems carrying the nit. The eyelashes regain their normal length within a few days.

Adult↗
PubMed1984

Relative roles of upper and lower lacrimal canaliculi in normal tear drainage.

A total of 88 cases of impaction of the eyelash into the lacrimal punctum were collected from 34,256 outpatients, and 39 cases of lash impaction into the Meibomian gland duct were found among 30,456 outpatients. Observations of these patients were analyzed to find the relative roles of the upper and lower lacrimal canaliculi in the normal tear drainage. In the cases of the Meibomian gland duct, the impaction occurred at a similar incidence in the upper and lower eyelids. However, in the cases of the punctum, the upper punctum was affected about three times more frequently than the lower punctum. The impaction of the eyelashes probably occurred at about the same rate in both puncta, but the present results suggested that the lashes in the lower punctum disappeared more easily into the drainage system than the lashes in the upper punctum. The lower canaliculus should, therefore, play the major role in normal tear drainage.

Eyelashes↗
PubMedDate not supplied

[Surgical treatment of traumatic madarosis].

Traumatic madarosis is a cosmetic and anatomo-functional problem. Besides the repair of the eyelashes proper, the clinical status of the patient requires repair of the carcass of the damaged eyelid in order to prevent lagophthalmos. The technique of transplanting a free hairy graft from the eyebrows is described. The results of treatment were assessed by the following parameters: the flap taking in, thickness and direction of the new lashes growth, and stability of the eyelid. Complete healing of the graft and stability of the eyelid were attained in all the cases. Good thickness of the eyelashes and the ideal direction of their growth were more difficult to achieve. The causes of failures are discussed. Despite the shortcomings, the method of treating traumatic madarosis proved to be effective and is recommended for clinical use.

Evaluation Studies as Topic↗
PubMed2001

Effect of dexmedetomidine on propofol requirements in healthy subjects.

Dexmedetomidine-propofol pharmacodynamic interaction was evaluated in nine healthy subjects in a crossover design. Dexmedetomidine/placebo was infused using a computer-controlled infusion pump (CCIP) to maintain a pseudo-steady-state plasma concentration of 0.66 +/- 0.080 or 0 ng/mL, respectively. Forty-five minutes after the dexmedetomidine/placebo infusion was started, propofol was infused using a second CCIP to achieve a stepwise logarithmically ascending propofol concentration (1.00 to 13.8 microg/mL) profile. Each propofol step lasted 10 min. Blood was sampled for plasma concentration determination, and pharmacodynamic endpoint assessments were made during the study. Propofol and dexmedetomidine/placebo infusions were terminated when three endpoints (subjects were too sedated to hold a syringe, followed by loss of eyelash reflex, followed by loss of motor response to electrical stimulation) were achieved sequentially. The concentration of propofol associated with 50% probability of achieving a pharmacodynamic endpoint in the absence of dexmedetomidine (EC50; placebo treatment) was 6.63 microg/mL for motor response to electrical stimulation and ranged from 1.14 to 1.98 microg/mL for the ability to hold a syringe, eyelash reflex, and sedation scores. The apparent EC50 values of propofol (EC50APP; concentration of propofol at which the probability of achieving a pharmacodynamic endpoint is 50% in the presence of dexmedetomidine concentrations observed in the current study; dexmedetomidine treatment) were 0.273, 0.544-0.643, and 3.89 microg/mL for the ability to hold a syringe, sedation scores, and motor response, respectively. Dexmedetomidine reduced propofol concentrations required for sedation and suppression of motor response. Therefore, the propofol dose required for sedation and induction of anesthesia may have to be reduced in the presence of dexmedetomidine.

Adolescent↗
PubMed2001

Pretarsal fat compartment in the lower eyelid.

It is generally accepted that there are three infraorbital fat regions in the lower eyelid; medial, central, and lateral compartments. However, removing only the fat in the lateral compartment does not remove the bulge just below the eyelashes, which is caused by another fat pad. The aim of this study was to describe the anatomy of the pretarsal fat compartment and to demonstrate its clinical implications in lower lid blepharoplasty. Ten cadavers (total 20 lower eyelids) were studied. A skin-muscle flap was reflected to expose the soft pretarsal structures. A small stab incision was made on the lateral portion of the sac containing fat on the tarsus. Methylene blue dye was injected into the sac. Specimens were fixed and sagittal sections in four different planes were prepared for histological analysis. The injected dye remained within the sac and demarcated it as a pear or cone shaped structure. This encapsulated fat compartment sits on the lateral half of the tarsal plate above the lateral compartment fat. Auxillary or submuscular fat is well known. This study, however, designates the pretarsal fat as "encapsulated" in a compartment instead of being unbound. We have named it the "pretarsal fat compartment." Histologically, orbital septal fibers separate "pretarsal fat" from lateral infraorbital fat. It is recommended that fat in the pretarsal fat compartment be removed during lower lid blepharoplasty in order to alleviate the bulge or knoll of the skin just below the lower eyelashes.

Adipose Tissue↗
PubMed1996

[Age-related correlation between EEG parameters and depth of anesthesia under propofol. Effect of fentanyl].

UNLABELLED: This study was designed to determine the relationship between the electroencephalogram (EEG) and clinical signs of depth of anaesthesia during induction of anaesthesia by slow infusion of propofol (18 mg/kg.h). METHODS: Four groups of 12 patients each were studied (groups I and II: 18-50 years; groups III and IV: > 70 years). Groups II and IV were given 0.15 mg fentanyl before the infusion of propofol was started. The clinical signs recorded were: (1) loss of eyelash reflex; (2) respiratory insufficiency; (3) tolerance to painful stimuli; and (4) intubation. Cardiovascular reactions were documented. The dosage was calculated from the infusion time (time from start of infusion until specific clinical event). Bipolar electrodes were placed at the C4/P4 positions (10-20 placement system) to record the EEG, which was processed by a personal computer (Narkograph) using fast-fourier transformation. The Narkograph calculates multiparametric EEG stages ranging from A to F (according to Kugler) as well as median frequency and spectral-edge frequency 95% (SEF). Stage A represents alpha rhythm, stage F is equivalent to a burst suppression pattern. For statistical analysis a Student t-test was performed. RESULTS: The infusion of propofol led to slowly developing anaesthesia with loss of eyelash reflex followed by loss of pain response, respiratory insufficiency, and intubation. In the younger patients the clinical signs coincided with well-differentiable EEG patterns. Above 70 years of age there were problems in distinguishing the EEG patterns, as there are alterations of the EEG with advanced age. The multiparametric EEG stage calculated by the Narkograph showed a better correlation with the clinical signs than median or SEF. Fentanyl shortened the induction time remarkably: less propofol was needed to achieve corresponding clinical signs when fentanyl was added. The EEG patterns typical for a specific clinical condition remained unchanged by fentanyl. Similar clinical situations showed equal EEG stages in all groups. Different clinical situations could be distinguished by significant changes in the EEG. The infusion times for tolerance to pain and respiratory insufficiency were not significantly different, and there were no significant differences between the EEG patterns and propofol doses for these two clinical parameters. Intubation was performed after 18.5 +/- 4.6 min in group I with a propofol dose of 5.6 +/- 1.4 mg/kg. This time was shortened by fentanyl in group II to 10.1 +/- 3.7 min and a propofol dose of 3.0 +/- 1.1 mg/kg. CONCLUSION: Different clinical signs corresponding to different levels of depth of anaesthesia could be differentiated by their EEG parameters. The EEG stage allowed better differentiation of the clinical conditions than the single-parameter EEG derivatives median and SEF. The results of this study show that EEG monitoring provides information about depth of anaesthesia.

Adjuvants, Anesthesia↗
PubMed2004

Dose-finding study of intravenous midazolam for sedation and amnesia during spinal anesthesia in patients premedicated with intramuscular midazolam.

PURPOSE: We investigated the effective and safe dose of intravenous midazolam for sedation and amnesia during spinal anesthesia in patients premedicated with intramuscular midazolam. METHODS: One hundred and eighty patients aged 20-50 years scheduled for spinal anesthesia received midazolam 0.06 mg.kg(-1) and atropine 0.01 mg.kg(-1) intramuscularly 15 min before entering the operating room. Spinal anesthesia was performed with 0.5% hyperbaric tetracaine. Five minutes after starting surgery, midazolam 0 (control group), 0.01, 0.02, 0.03, 0.04, or 0.05 mg.kg(-1) was intravenously administered (30 patients each). Blood pressure, heart rate, respiratory rate, percutaneous oxygen saturation (S(p)(O)(2)), verbal response, eyelash reflex, and involuntary body movement were measured every 5 min for 30 min. Memory during surgery was also investigated. RESULTS: The number of the patients with loss of verbal response, with loss of eyelash reflex, and with no memory during surgery were significantly larger in the groups receiving midazolam >or=0.03 mg.kg(-1), >or=0.04 mg.kg(-1), and >or=0.02 mg.kg(-1), respectively. The decrease in blood pressure or increase in respiratory rate with decrease in S(p)(O)(2) was significantly larger in the groups receiving midazolam >or=0.03 mg.kg(-1) or 0.05 mg.kg(-1), respectively. CONCLUSION: For sedation and amnesia of the patients aged 20-50 years in spinal anesthesia with about 1 h duration receiving intramuscular midazolam 0.06 mg.kg(-1) as a premedication, intravenous midazolam 0.02 mg.kg(-1) might be effective and safe.

Adult↗
PubMed2003

Vital capacity induction with 8% sevoflurane and N2o causes cerebral hyperemia.

PURPOSE: Little is known about the influence of high-dose sevoflurane on cerebral volume. We evaluated induction time and cerebral blood volume with 8% sevoflurane using the "vital capacity induction" technique. METHODS: Thirty-four patients were randomly allocated into three groups. Group P received 2.0 mg x kg(-1) of propofol i.v. and inhalation of 67% N2o/O2, whereas group S5 and group S8 received inhalation of primed 5% and 8% sevoflurane in 67% N2O/O2, respectively. Induction time was measured as the time from the start of inhalation, or from the end of injection, until loss of eyelash reflex. Near-infrared spectroscopy and bispectral index (BIS) were monitored continuously until 3 min after tracheal intubation. RESULTS: Induction time was less in group S8 (17.3 +/- 6.4s, mean +/- SD) than in groups P (25.7 +/- 8.2s) and S5 (33.0 +/- 16.8s). There was a significant increase in cerebral blood volume after intubation in group S8, as suggested by higher cerebral oxyhemoglobin and total hemoglobin levels. There were no differences in BIS scores among the groups during the study period. CONCLUSION: Vital capacity inhalation of 8% sevoflurane produces a faster loss of eyelash reflex than does 5% sevoflurane or propofol, but increases cerebral blood volume.

Anesthesia, General↗
PubMedDate not supplied

Latanoprost and pigmentation.

Latanoprost is a prostaglandin analogue with well-established efficacy in the treatment of open-angle glaucoma and ocular hypertension. Once-daily administration of this drug for up to 5 years is generally well tolerated both locally and systemically. While most reported side effects have been classified as mild in intensity, an increase in iris, eyelash, and periocular pigmentation has been associated with prostaglandin analogue use in some patients. Follow-up studies of patients withdrawn from latanoprost treatment suggest that the increased iridial pigmentation is irreversible while changes in eyelash and periocular skin pigmentation are reversible after cessation of therapy. Concern as to whether latanoprost affects proliferation of iridial melanocytes or other cellular components prompted investigation into its mechanism of action. All available evidence from in vitro, in vivo, and clinical studies suggests that latanoprost does not induce melanocyte proliferation. Morphologic study of human peripheral iridectomy specimens did not reveal any significant latanoprost-induced pathologic change in the iris. There was no evidence of melanin granules blocking the outflow pathways in treated patients. Stimulation of melanogenesis in iridial melanocytes, perhaps through an effect on tyrosinase, appears to account for induction of melanin production. Additional studies are in progress to further elucidate the mechanism of latanoprost-induced increased iridial pigmentation.

Antihypertensive Agents↗
PubMed2006

Beat-by-beat cardiovascular index to predict unexpected intraoperative movement in anesthetized unparalyzed patients: a retrospective analysis.

OBJECTIVE: Unexpected intraoperative movement may be detrimental during delicate surgery. This study tested retrospectively an algorithm based on beat-by-beat circulatory variables (incorporated into a Cardiovascular depth of anesthesia index: CARDEAN in relationship to unexpected movement, and compared its performance to that of the electroencephalogram (EEG)-derived index: BIS-XP 4.0. METHODS: 40 ASA I or II patients presenting for knee surgery had EEG (BIS XP 4.0), beat-by-beat (Finapres) finger non-invasive blood pressure (BP), conventional brachial BP and electrocardiogram (EKG) monitors attached. Anesthesia was induced and maintained with propofol and remifentanil. Before incision, the propofol concentration was set to maintain BIS < 60. From incision to emergence, the anesthesiologist was denied access to BIS or Finapres. Anesthesia adjustment was titrated at the discretion of the anesthesiologist according to conventional signs only: brachial BP, EKG, eyelash reflex, movement. Occurrences of movement and eye signs (divergence of eyeballs, tears, corneal reflex, eyelash reflex) were observed. The CARDEAN algorithm was written retrospectively and tested vs. BIS. RESULTS: 11 movements occurred in 8 patients. CARDEAN > 60 predicted movement in 30% of the cases, 15 to 274 s before movement (sensitivity: 100%, specificity: 95%; relative operating curve ROC = 0.98; prediction probability pk = 0.98). BIS > 60 predicted movement in 19% of cases (sensitivity: 64%; specificity: 94%, ROC: 0.85, pk: 0.85). CONCLUSION: Retrospectively, a cardiovascular index predicted unexpected intraoperative movements. Prospective validation is needed.

Algorithms↗