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PubMed1996

[Value of cyanoacrylate tissue adhesives in peripheral corneal ulcers of inflammatory origin].

PURPOSE: To investigate cyanoacrylate tissue adhesives in ulcerative keratitis. They represent one of the best emergency treatments of corneal descemetoceles, preperforated corneal ulcers, impending corneal perforations and small corneal perforations. METHODS: Nine patients presenting with peripheral ulcerative keratitis were treated by this method between 1990 and 1994. The underlying diseases included Mooren's ulcer (5 eyes), rosacea (2 eyes) and rheumatoid arthritis (2 eyes). RESULTS: Despite the poor prognosis of ulcerative keratitis, good healing and corneal re-epithelialization were obtained in 6 cases (66%) without any relapse. Severe infectious complications occurred in 1 case (11%) and required a therapeutic penetrating keratoplasty. CONCLUSIONS: Cyanoacrylate tissue adhesives are an effective and well tolerated treatment of peripheral ulcerative keratitis associated with ocular inflammatory diseases. Potential infectious complications impose a strict follow-up.

Aged↗

PubMed1996

Collagen abnormalities in conjunctiva of patients with cicatricial pemphigoid.

The purpose of this study was to analyze the distribution and types of collagen in the substantia propria of the conjunctiva of patients with ocular cicatricial pemphigoid (OCP). Biopsy specimens were collected from 10 patients with active OCP, five patients with active Behçet's disease, nine patients with atopic keratoconjunctivitis, five patients with chronic rosacea blepharoconjunctivitis, and six normal patients undergoing cataract surgery. Cryostat tissue sections were cut and stained using an indirect immunofluorescence technique, employing a panel of primary antibodies directed against seven collagen types. Differences between OCP, Behçet's, and normal conjunctiva were seen in the staining for collagen types III, IV, and VII. The intensity of staining for type III collagen was increased in the substantia propria of OCP conjunctiva as compared to the other groups. The basement membrane zone (BMZ) of OCP patients was typically disrupted and fragmented in appearance when stained for type IV collagen, a finding not seen in the non-OCP specimens. The BMZ staining pattern for type VII collagen in OCP conjunctiva was even more disrupted than that seen for type IV collagen, particularly on the posterior side, which was thickened and reduplicated with short fibers extending into the superficial stroma. The production of type III collagen by fibroblasts of the substantia propria is a common feature of diseases associated with subepithelial fibrosis. The damage to the epithelial BMZ and the subsequent attempt at repair with aberrant type IV and VII collagen production are unique to conjunctiva affected by OCP.

Collagen↗

PubMed1997

Esculetin in Alchemilla speciosa: identification and antimutagenic properties.

Quercetin, an ubiquitously occurring plant mutagen was detected and quantified in a methanolic extract prepared from the herb of Alchemilla speciosa BUSER (Rosaceae). However, the extract exhibited much less mutagenicity in Salmonella typhimurium than expected from its quercetin content. A bioassay guided fractionation resulted in a crude fraction in which esculetin was present, as evidenced by GC/MS analysis. This coumarin derivative was detected for the first time in an Alchemilla species. It was at least partly responsible for the inhibition of the quercetin mutagenicity. Esculetin was also found to be active against certain mutagens which need metabolic activation. Its activity was comparable or even more pronounced than that of other plant coumarins.

Animals↗

PubMed1997

Rhinophyma: treatment with CO2 laser.

Rhinophyma is an acne rosacea which primarily affects the midface of elderly men, and causes disfigurement as well as obstruction. There are numerous ways of treating this condition and, in our institution, a CO2 laser is the treatment of choice.

Adult↗

PubMed1997

The most common dermatologic problems identified by family physicians, 1990-1994.

BACKGROUND AND OBJECTIVES: Because all family physicians see numerous patients with dermatologic complaints, their education in skin disorders is important. Data are needed to help program directors know which areas of dermatology deserve the most time and emphasis. This study determined what types of skin problems family physicians most commonly diagnose. METHODS: Study researchers analyzed National Ambulatory Medical Care Survey data from 1990 to 1994 for dermatologic diagnoses. We then compared physicians specializing in family practice and its related fields (general practice, family practice sports medicine, and family practice geriatrics) with dermatologists and other physicians. RESULTS: The most common skin disorders diagnosed by family physicians were dermatitis (16.4% of all diagnoses), pyoderma (13.7%), wart (8%), tinea infection (5.4%), and epidermoid cyst (5.1%). The top 10 most common diagnoses accounted for 65% of all skin-related diagnoses, and the top 20 most common diagnoses accounted for 81.8%. Family physicians more commonly saw patients for infectious processes, infestations, and insect bites, while dermatologists were more likely to see patients for psoriasis, alopecia, and rosacea. CONCLUSIONS: Skin disorders diagnosed by family physicians differ considerably from those diagnosed by dermatologists. Because dermatologists do much of the dermatology teaching of family practice residents, it is important to recognize these dissimilarities to place emphasis on the proper areas of study. Some common or serious conditions, such as psoriasis and melanoma, are not often diagnosed by family physicians and also deserve attention in family practice training programs.

Clinical Competence↗

PubMed1997

Helicobacter pylori: beyond peptic ulcer disease.

Beyond peptic ulcer disease, Helicobacter pylori infection is associated with intestinal-type gastric cancer and low-grade gastric mucosa-associated lymphoid tissue (MALT) lymphoma. It is also currently implicated as a possible cause of dyspepsia and extraintestinal disorders such as coronary artery disease, rosacea, chronic urticaria, and delayed growth in children. There are strong epidemiological data from large cohort studies linking H. pylori to gastric adenocarcinoma. Several cofactors, including early childhood acquisition of infection, strain-specific differences, genetic predisposition of the host, and the environment, appear to play a role in the progression of chronic gastritis to gastric cancer. H. pylori infection is seen in over 90% of MALT lymphomas, and about 70% of localized nonbulky tumors will undergo complete histological regression after eradication of the bacterium. Because follow-up data are limited to less than 2 years, those undergoing H. pylori eradication as primary therapy for MALT lymphoma require frequent histological surveillance for tumor recurrence. There are conflicting data from short-term studies regarding the effect of H. pylori eradication on dyspeptic symptoms. The decision to test or not for H. pylori in the dyspeptic patient may become easier when well-controlled studies with longer periods of follow-up become available. Because H. pylori induces a systemic inflammatory response, investigators are beginning to explore possible extraintestinal disease associations with the infection. The global prevalence of both peptic ulcer disease and gastric cancer has led to studies focusing on noninvasive screening for H. pylori in high-risk populations and prevention of primary infection by means of vaccination.

Adenocarcinoma↗

PubMed1997

[Endophthalmitis after cataract surgery: long-term follow-up].

BACKGROUND: Endophthalmitis is a serious complication after cataract surgery. PATIENTS AND METHODS: Therefore, a retrospective study was performed by reviewing patient-records of all cases of end-ophthalmitis after catract surgery that were treated at the department of ophthalmology of the University Hospital in Mainz between January 1986 and December 1995. RESULTS: 44 eyes were treated for endophthalmitis. Of those, 38 had been referred. In 15 eyes cataract surgery was performed on an outpatient basis. In 20 cases the onset of end-ophthalmitis occurred within the first postoperative week. We isolated staphylococcus epidermidis (14), staphylococcus aureus (4), other gram-positive microorganisms (15), gram-negative bacteria (2) and candida (1). As risk factors we found a wound dehiscence (14), an intraoperative loss of vitreous (11), diabetes (11), skin-diseases like rosacea or neurodermatitis (6). In 36 cases a vitrectomy was performed. After a mean follow-up of 25 +/- 22 months 26 patients had a visual acuity of 0.05 or better. CONCLUSION: Gram-positive bacteria showed to be the most common causetive microorganisms. In a third of all cases the sample demonstrated no growth. More than 80% of the eyes were treated by vitrectomy. About 60% of the patients obtained a visual acuity of 0.05 or better.

Adult↗

PubMed1998

Cutaneous sporotrichosis presenting as a keratoacanthoma.

Sporothrix schenckii is a ubiquitous dimorphic fungus with a variety of clinical presentations, including imitation of other diseases such as pyoderma, rosacea, and pyoderma gangrenosum. A case in which sporotrichosis appeared as a keratoacanthoma-like nodule on the lower lip of a young woman is presented, with treatment considerations and diagnostic pitfalls.

Adult↗

PubMed1997

Clinician's Photo Guide To Recognizing and Treating Skin Diseases in Women: Part 1. Dermatoses Not Linked to Pregnancy.

The clinical presentation of certain dermatologic conditions differs between women and men; this may be especially true when women are perimenstrual or pregnant. Skin diseases that erupt or become aggravated during the perimenstrual period include autoimmune progesterone dermatitis and melasma. Dermatologic conditions that may be exacerbated perimenstrually include acne vulgaris, rosacea, lupus erythematosus, psoriasis, atopic eczema, lichen planus, dermatitis herpetiformis, erythema multiforme, and urticaria. The hormonal effects of increased cutaneous vascularity, seborrhea, and dermal edema during the perimenstrual period may account for the eruption of or increase in severity of these diseases. Clinical presentation, differential diagnoses, and treatment options for select cutaneous conditions are discussed.

Journal Article↗

PubMedDate not supplied

Pollen calendar of the city of Salamanca (Spain). Aeropalynological analysis for 1981-1982 and 1991-1992.

We report a study on the contents of airborne pollen in the city of Salamanca (Spain) aimed at establishing a pollen calendar for the city for the yearly periods of maximum concentrations, relating these with quantifiable atmospheric variables over two two-year periods with an interval of 10 years between them: 1981-82 and 1991-92. The pollen was captured with Burkard spore-traps, based on Hirst's volumetric method. Determinations were made daily and were used to make preparations, previously stained with basic fuscin, for study under light microscopy at x 1,000 magnification. 946 preparations were analyzed, corresponding to the same number of days distributed over 150 weeks of the periods studied. The results afforded the identification of 48 different types of pollen grain: Grasses (Poaceae), Olea europea (olive), Quercus rotundifolia (Holm-oak), other Quercus spp. (Q. pyrenaica, Q. suber, Q. faginea, etc.), Cupressaceae (Cupressus sempervivens, C. arizonica, Juniperus communis etc.), Plantago (Plantago lanceolata, Plantago media, etc.), Pinaceae (Pinus communis, Abies alba, etc.), Rumex sp. (osier), Urtica dioica (nettle), Parietaria (Parietaria officinalis, P. judaica), Chenopodio-Amaranthaceae (Chenopodium sp., Amaranthus sp., Salsola kali, etc.), Artemisia vulgaris (Artemisia), other Compositae (Taraxacum officinalis, Hellianthus sp. etc.), Castanea sativa (Chestnut), Ligustrum sp. (privet), Betula sp. (birch), Alnus sp. (common alder), Fraxinus sp (ash), Populus sp. (poplar), Salix sp. (willow), Ulmus sp. (elm), Platanus sp. (plantain, plane), Carex sp. (sweet flag), Erica sp. (common heather), Leguminosae or Fabaceae:--Papillionaceae (Medicago sp.; Cercis sp., Robina sp.)--Cesalpinoideae Acacia sp. (Acacia),--Mimosoideae: Sophora japonica, Umbelliferae (Foeniculum sp., Cirsium sp., etc.), Centaurea sp., Cistus sp. (rock rose), Typha sp (bulrush), Mirtaceae (Myrtus communis), Juglans regia (Walnut), Galium verum, Filipendula sp. (spirea/drop wort), Rosaceae (Pyrus sp., Prunus sp., etc.), Tilia sp. (Linden), Morus sp. (mulberry), Taxus baccata (yew), Papaveraceae (Papaver rhoeas etc.), Labiata (Lavandula sp.), Cannabaceae (Humulus sp. etc.), Liliaceae (Lilium sp.), Echium sp. (viper's bugloss). The most abundant taxa, detected in the highest quantities (grains/m3 air), by order of counting were as follows: holm-oak, olive, grasses, Plantago and Parietaria. With the data obtained we have established a pollen calendar for Salamanca and report the period in which each type of pollen is found along the years and the periods with the highest airborne concentrations of such pollens. The diversity and the spectrum of the pollen in the city of Salamanca correspond to the typical plant communities found on the dehesas (large ranges of grasslands) of Castile, where Salamanca is located, although the wind directions and the peculiar climatic characteristics of the area govern the peaks of maximum presence of the different taxa. As examples, in the case of olive, which is cultivated at some distance from the city, its maximum presence coincides with south-westerly winds; in the case of grasses, the peaks of maximum counts coincide with a sharp rise in mean temperature, close to or higher than 20 degrees C and between five and six weeks after rainfall equal to or greater than 5 L/m2.

Air↗

PubMed1961