[Round table on bioavailability].
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Biomedical subjects
Publications and source records attributed to A Tassy.
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To be effective, an antibiotic must achieve therapeutic concentrations at the site of infection. This article is a review on the bioavailability of local and systemic antibiotics. Amongst topical antibiotics, fluoroquinolones and fusidic acid have the best intra-corneal and intra-cameral penetration. Chloramphenicol penetrates the anterior chamber but not always at therepeutic levels. Serum levels are low from topical administration, and haematological toxicity of chloramphenicol eyedrops is still not proven. Amongst systemic antibiotics, the molecules capable of penetrating the eye at therapeutic levels are fosfomycin, imipenem, some of third generation cephalosporins, fluoroquinolones and ureidopenicillins. Intra-ocular penetration of antibiotics is increased by infection, corneal epithelium abrasion, increasing dose frequency or delivery using a biomaterial reservoir (soft contact lenses or collagen schields). Antibiotic-antiinflammatory associations can make infected sites more accessible to antibiotics. The choice of a treatment must take in consideration molecules, dosing and route, and be adapted to the germ to kill and the infected site to treat.
PURPOSE: To analyze effectiveness and side effects of thiotepa eyedrops utilized to prevent postoperative pterygium recurrence, with a retrospective study allowing a long follow-up. METHODS: This work deals with 64 cases of pterygium, among them 8 were recurrent. Only growing or very important pterygiums were operated on (14 cases were reaching the pupillary area). Surgical techniques were simple ones (almost always excision with simple conjunctival closure or translation of conjunctival flaps, no corneal grafts). Following surgery, patients received thiotepa eyedrops (dilution: 1/2000), four times a day, during 6 to 8 weeks. RESULTS: Tolerance of treatment was good on the whole, and there was no important complications. There were only 2 cases of recurrence (3%). CONCLUSION: Thiotepa was effective and allowed us to avoid using complex surgical techniques to prevent recurrence (especially corneal grafts), even in recurrent pterygiums or pterygiums reaching the pupillary area.
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The value of the pursuit motor electro-oculogram (pendular or linear) in the diagnosis and subsequent therapy of non-accomodative esotropia (not eliminated by optical correction), and presenting a spasmodic element, was studied in 164 cases of unoperated esotropia and 47 cases operated upon using a conventional technique and "Cuppers'thread". The contribution and limitations of this electrophysiological method for exploration of ocular motility in esotropia are discussed.
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