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Biomedical subjects

A A Bialasiewicz

Publications and source records attributed to A A Bialasiewicz.

At least 19 recordsLinked to original sources
PubMed1992

[Incidence of postoperative bacterial infections after planned intraocular interventions].

Between August 1982 and August 1984 3059 intraocular operations were performed with topical prophylactic antibiotics. Results of conjunctival cultures did not influence the surgical schedule. 8179 intraocular operations were performed between September 1984 and August 1988. An intraocular operation was postponed until conjunctival cultures were negative using topical antibiotics administered at hourly intervals. The rate of postoperative intraocular infections decreased significantly (p less than 0.0001) from 21 (0.69%) of 3059 during the first to 9 (0.11%) of 8179 intraocular operations during the second observation period. In the first period 11 vitrectomies and 2 enucleations due to bacterial endophthalmitis had to be performed. In the second period 2 vitrectomies and no enucleations were necessary (p less than 0.0001). Our results indicate, that decontamination of the conjunctiva may be an import factor for the prevention of postoperative endophthalmitis following elective intraocular surgery.

Adult↗
PubMed1992

[Unilateral chronic granulomatous blepharitis as a leading symptom of Oriental cutaneous leishmaniasis in Germany. Giesma stain as rapid diagnosis and initial description of systemic therapy with gamma-interferon].

Nine months after leaving the Lebanon, a four-year-old immigrant boy presented with a 5 months history of blepharitis. The lesion remained therapy-resistant for aminoglycoside antibiotics. Six months later, the patient presented with an indolent granulomatous necrotizing purulent blepharitis and follicular conjunctivitis. Diagnosis was made by Giemsa stain and histopathology, which revealed amastigotes in macrophages consistent with the diagnosis of oriental cutaneous leishmaniasis. Therapy with systemic recombinant gamma Interferon, which is described for the first time in this disease entity, resulted in a successful primary healing of the cutaneous lesion. Self-healing epithelial keratitis was the only side-effect observed. Ophthalmologists in Germany should be aware of the differential diagnosis of oriental cutaneous Leishmaniasis in patients suffering from chronic granulomatous lid lesions of patients from countries endemic/epidemic for Leishmaniasis. Laboratory diagnosis is simple. Insights into the immunology of infection have made possible novel therapeutic avenues using gamma-Interferon being effective without serve side-effects and allowing for a good primary healing of the cutaneous lesions.

Biopsy↗
PubMed1991

[Disseminated choroiditis, papillitis and vasculitis retinae as main findings in lues II-III].

Intraocular inflammations as chief manifestation of a T. pallidum infection associated with stage II syphilis are rarely documented in the recent literature. We report on a 35 year old patient with bilateral choroiditis, retinal vasculitis and papillitis persisting retrospectively since he had received some medication for syphilis 8 years previously. This patient was at high risk for other sexually transmitted diseases, however, he did not show HIV-seroconversion. General symptoms like uneasiness, fatigue, depressions and intermittent weight loss were mentioned. Reduction of visual acuity with topical corticosteroid therapy led to another medical work-up, and a systemic therapy with Ceftriaxone for 14 days resulted in better vision, better perimetric results and less inflammatory cell in the vitreous but evident optic atrophy.

Adult↗
PubMed1991

[Preoperative microbiologic diagnosis before elective intraocular interventions and prevention of infection with tobramycin eyedrops. Results of a multicenter study].

Preoperative conjunctival smears of 313 asymptomatic patients before cataract surgery were evaluated in an open multi-center study in 10 German surgical eye care centers from May to August 1987. 230 evaluable isolates of 198 patients (= 61.1%) on agar plates with a 48 h incubation period revealed 190 gram-positive (most frequent isolates: 62.2% coagulase negative Staph., 13.5% coagulase positive Staph.) and 40 gram negative agents (most frequent isolates: 3.0% Proteus sp., 2.2% Pseudomonas sp.). Coinfections with gram-positive organisms were seen in 22%, and with gram-negative organisms in 9% of cases. Newly acquired potentially pathogenic bacteria were demonstrated after one day (5-8 drops 3 mg/ml Tobramycin (Tobramaxin; 1 x ointment in the evening 3 mg/100 mg Tobramycin (Tobramaxin] of topical prophylaxis in 6 of 115 (= 5.2%) previously negative and 22 of 198 (= 11%) previously positive conjunctival cultures. Coagulase negative Tobramycin sensitive Staph. persisted in 41 of 110 patients (= 37.3%) and coagulase positive Tobramycin-sensitive Staph. in 4 of 30 (= 13.3%). Each of the gram-negative bacteria could be eliminated after one day of topical prophylaxis with Tobramycin eye drops and ointment in this study. The statistically determined elimination rate estimated for a one-day topical prophylaxis with Tobramycin in asymptomatic culture-positive persons was 77.5-89.8% (95% confidence interval/Pearson and Clopper). The statistically determined probability for potentially pathogenic bacteria in a previously culture-negative patient after topical preoperative Tobramycin prophylaxis was 3.1-13.2% (95% confidence interval/Pearson and Clopper). Thus, additional supportive antibiotic measures are to be taken pre- and perioperatively by the intraocular surgeon to minimize the risk of postoperative endophthalmitis.

Adolescent↗
PubMed1991

[Bilateral traumatic eye avulsion].

A 26 year old patient with a LeFort III fracture after an automobile accident exhibited bilateral luxation of the globes. An avulsio imcompleta with an evulsion of the optic nerve posteriorly was noted on his right eye and an avulsio incompleta with evulsion of the optic nerve anteriorly was seen on his left eye as a cause for the luxation. The said locations may represent predilection sites for an evulsion of the optic nerve.

Adult↗
PubMed1991

[Postoperative infections in systemic immunocompromising diseases. A study of 6 patients].

Advances of therapeutic strategies in the management of critically ill patients have resulted in an increased life expectancy and more frequent presentations to ophthalmic surgeons. Six patients with postoperative endophthalmitis after elective intraocular surgery suffering from Sharp-syndrome, metastasizing antrum carcinoma, granulomatous vasculitis and immunosuppressive therapy, agranulocytosis, silico-tuberculosis and chronic lymphatic leukemia revealed traditionally pathogenic agents (Proteus mirabilis, P. aeruginosa, enterococci, coagulase-negative Staph). Two patients had to be enucleated, one turned blind and three had a visual acuity 5/100 to 20/60. In our hands prognosis for successful therapy in immunodeficient patients seems worse than in otherwise healthy persons. Painstaking evaluation of history, medical work-up, conjunctival swabs and application of bactericidal topical antibiotics preoperatively and perioperatively are particularly important in these patients.

Aged↗
PubMed1990

[Staphylococcal endophthalmitis following squint surgery].

A 10-year-old boy was referred to the authors three days after bimedial faden operation (posterior fixation), with a purulent endophthalmitis in his right eye and visual acuity of LP. Systemic combined antibiotics "ad hoc", including cephalosporins and amikacin, were administered in combination with immunosuppressive doses of methylprednisolone after swabs had been taken for bacteriologic workup. Nine days after admission a pars plana vitrectomy was performed. Both the conjunctival swabs and the vitreous aspirate grew coagulase-negative, gram-positive cocci with high colony counts. Traction retinal detachment developed, and 30 days after the squint surgery lensectomy and silicone oil instillation had to be performed. Visual acuity 3 months after squint surgery was RE cc 0.2.

Amikacin↗
PubMed1990

[Choriocapillaritis (so-called pigment epitheliitis) in Borrelia burgdorferi seroconversion].

A significant B. burgdorferi seroconversion with an IgM of 1:80 was observed in a patient complaining of loss of vision in his right eye. The finding correlated morphologically with hyperpigmentation and depigmentation in the macular region, similar to pigment epitheliitis or choriocapillaritis. In the course of the following four weeks the IgM decreased by four titer steps. The visual acuity of the patient's right eye recovered from 0.4 on admission to 1.0 on discharge. The angiogram did not reveal any pathology. Since choroidal manifestations have often been documented in patients with B. burgdorferi infections, it is recommended that serological workups be performed in such patients. Studies in larger groups of patients are necessary to establish the relevance of this case report and its significance concerning infection as a cause of choriocapillaritis.

Adult↗
PubMed1990

[Ischemic optic neuropathy (apoplexia papillae) and ischemic micro-infarcts of the retinal nerve fiber layer in extreme internal carotid artery kinking].

The authors report on 2 patients with extreme kinking of the internal carotid artery and ipsilateral, recurrent ischemic optic neuropathy associated with localized microangiopathy of the retinal nerve fiber layer (cotton wool spots). In conjunction with the kinking phenomenon, the atheromatous plaques represent a potential cause of dangerous embolization causing ocular symptoms. The kinking phenomenon may not be diagnosed by Doppler sonography, including duplex B-scan evaluation, and digital subtraction angiography may be necessary. Extreme kinking of the internal carotid artery, which causes ocular embolisms, must be recognized and treated immediately by angioplasty to prevent damage to the eyes and brain.

Aged↗
PubMed1990

[Subretinal granuloma with calcinosis in toxocariasis].

A 27 year old male patient with a subretinal granuloma was diagnosed as having a serologically established toxocara infection (Immunoprecipitation test in living larva). Calcifications could be demonstrated in X-ray and CT-scan imaging. The significance of calcifications for the differential diagnosis of retinoblastoma must be seen in relative terms.

Adult↗
PubMed1990

[Diagnosis and therapy of acute bacterial infections of the eye].

New knowledge in the understanding of infection immunology and the development of more effective antibiotics will influence the therapeutic options for extra- and intraocular bacterial diseases. The role of mucin with its high sIgA content, the glycoconjugate-mediated bacterial adherence phenomena of the cornea and conjunctiva, and the exact biomicroscopic classification can be constrated with the highly effective topically and systemically applicable antibiotics (e.g., Cephalosporins, Aminoglycosides, New Quinolones and Carbapenems). Recognition of the fact that the amplification mechanisms of the immune system are already fully activated when the clinical features of a serpent ulcer appear and that the destructive phase only represents an unwanted side-effect of the host defense mechanisms towards its own structures has resulted in the application of corticosteroids with simultaneous antibiotic medication and early tectonic perforating keratoplasty. Many intraocular inflammations of heretofore unknown etiology may be detected by modern diagnostic approaches as being localized manifestations of a systemic disease that can be properly treated (e.g., borreliosis, atypical syphilis). The incidence of "metastatic" endophthalmitis could be diminished in high-risk inpatients by preventive measures, including the elimination of potentially pathogenic agents with antibiotics (and antifungal drugs). Infection-associated intraocular inflammations ("Reiter's syndrome") have been linked to persisting pathogenic organisms at distant sites, thereby rendering themselves etiologically treatable (e.g., infections from Yersinia, Campylobaster, Urea-plasma, and Chlamydia). Except for a very few cases (use of monoclonal antibodies, serological methods and immunoblots), the diagnosis of bacterial infections is based on isolation of the organism concerned, which also represents a requirement for antibiotic susceptibility testing and, consequently a specific medication. Close cooperation with microbiologists and the direct culturing of isolates within ophthalmology clinics have seen a revival since the days of Theodor Axenfeld.

Anti-Bacterial Agents↗
PubMed1989

[Bilateral acute confluent disseminated choroiditis in Borrelia burgdorferi infection].

Two patients with bilateral extensive confluent choroidal lesions, exudative retinal detachments, positive lyme serology and a typical history are documented: A 32-year-old woman presented 14 days after a "flu-like" illness with bilateral acute extensive choroidal lesions and exudative retinal detachments (OD from 5 to 8:30 o'clock, OS from 5 to 8 o'clock, both including the macula) accompanied by a mild lymphocytic meningitis. The laboratory work-up revealed increased serum and CSF titers of antibodies against Borrelia burgdorferi (Lyme immunofluorescent test (IFT) and Lyme-IgM IFT) which declined after a 14-day treatment with doxycycline (200 mg/d), CSF titers non-detectable (serum IgG: from 1:640 to 1:320, serum IgM: from 1:40 to 1:20). A distinct improvement with visual acuity increasing from OD 0.2/OS 0.3 p to OD/OS 0.8 p was observed after seven days of treatment. A 40-year-old man with a 14-day history of tick-bite developed the same, though more severe ocular findings and a lymphocytic meningitis. The serological work-up revealed increased antibody titers against Borrelia burgdorferi (ELISA); the IgM titer was normal. After a 10-day treatment with penicillin, antibody titers against the spirochete decreased slightly and the patient's neurologic and ophthalmologic status improved dramatically. Five weeks after admission visual acuity was OD/OS 0.5 (compared to OD/OS 0.1) and has remained at 0.8 p (OD/OS) since the ninth week after onset. The clinical course of the disease and the decreasing lyme serology strongly suggest an infection with Borrelia burgdorferi. The authors propose thorough laboratory work-ups including tests for Lyme disease in selected patients with diffuse choroidal lesions.

Adult↗