[Asystole after intravenous administration of ranitidine].
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Heart Arrest↗
Biomedical subjects
P Rama
Publications and source records attributed to P Rama.
Expression of nerve growth factor receptors on the ocular surface in healthy subjects and during manifestation of inflammatory diseases.
PURPOSE: Recent studies have suggested the involvement of nerve growth factor (NGF) in the conjunctival inflammatory process and in corneal epithelium proliferation and differentiation. To verify the hypothesis that NGF could locally modulate the inflammatory and reparative processes, the authors evaluated the expression of NGF high-affinity receptor on the ocular surface in normal and pathologic conditions. METHODS: Ten conjunctival biopsies (obtained from three healthy subjects, five patients affected by vernal keratoconjunctivitis [VKC], and two patients with cicatricial pemphigoid [CP]) and five corneal specimens obtained from the Eye Bank of Veneto (Italy) were evaluated. All specimens were histologically stained, and immunohistochemistry was performed to identify the NGF high-affinity receptor (TrkA). RESULTS: All tissues expressed immunoreactivity for NGF receptors. In conjunctival specimens of healthy subjects, basal epithelial cells strongly expressed immunoreactivity and, in the stroma, rare cells were immunopositive for TrkA. No significant difference in immunoreactivity was observed in the conjunctival epithelium between healthy subjects and patients with inflammatory conjunctival diseases, whereas there were more immunopositive cells observed in the conjunctival stroma of VKC and CP patients than in the controls. The immunoreactivity in the cornea was confined to basal epithelial cells and endothelium. CONCLUSIONS: The NGF receptor is present on the human ocular surface. The authors' data support the possibility that NGF modulates ocular inflammation and corneal epithelial proliferation and differentiation through its receptors.
Adolescent↗
[Cortical blindess as symptom of pre-eclampsia].
Neurological complications during preeclampsia are not infrequent; the appearance of total blindness is rare, however. We report the case of a 32-year-old primipara with no outstanding history, who presented total loss of vision with no accompanying neurological symptoms during week 37 of the pregnancy. Effective early management of blood pressure to levels at which self-regulation of cerebral perfusion could be established allowed total recovery of vision 8 hours after admission to the intensive care recovery ward. Cranial computerized axial tomography (CAT) showed bilateral occipital subcortical edema that resolved after 8 days. The patient was released 13 days after admission with no sequelae.
Adult↗
Efficacy of organ preservation media enriched with nonlactate-generating substrate for maintaining tissue viability: a transplantation study.
BACKGROUND: Previously, isotonic solution (IS) enriched with beta-hydroxybutyrate, a nonlactate-generating substrate, was shown to be efficacious in maintaining tissues' ATP and metabolic activity under cold storage. The objective of this study was to verify these findings in terms of tissue viability in vivo. METHODS: Using a rabbit cornea transplantation model, efficacy of IS was studied and compared with McCarey-Kaufman medium, with or without beta-hydroxybutyrate, and other known media (Optisol and Likorol), with different properties and without beta-hydroxybutyrate. After storage at 4 degrees C for 6, 7, and 11 days, the corneas were grafted, and postoperative changes in corneal thickness, and endothelial cell density and morphology were monitored with a pachymeter and specular microscope. RESULTS: The experiments revealed that before grafting, IS effectively controlled tissue swelling for 7 days or longer, comparable to Optisol. When grafted, the IS-stored corneas deturgesced at high rates, with a short half-time (t1/2) for the de-swelling process, and the grafts remained thin and clear with an intact endothelium. This reflects excellent tissue viability. In the controls, the deturgescence process was extremely sluggish, with significantly lower rates and longer t1/2 (P= >0.01-0.05). Immediate swelling for 3-5 days after grafting was also observed with Optisol. These grafts had significant endothelium cell loss of 24-30% after 12 weeks (P= >0.01-0.02). CONCLUSIONS: IS is more efficacious than currently used media for sustaining the viability of donor corneas under cold storage. These findings may serve as a useful basis for future tests of IS in other organ storage systems.
3-Hydroxybutyric Acid↗
Excimer laser intrastromal keratomileusis.
We studied 30 eyes in 22 patients with severe myopia who underwent myopic keratomileusis combined with excimer laser refractive correction. The goals of the study were to evaluate the efficacy of the procedure in decreasing myopia, to assess the response of the cornea to intrastromal photoablation, and to examine the relationship between the number of laser pulses and the refractive correction achieved. The patients were observed for six months. The technique demonstrated a marked refractive reduction (from 171.875 +/- 3.32 diopters to -2.125 +/- 1.40 diopters) and an excellent corneal response to photoablation. An average decrease of 7.63 diopters was observed in keratometry readings. No marked change in the degree of astigmatism was observed after the procedure. Intrastromal haze was observed biomicroscopically in three of 30 eyes (10%). Postoperative best-corrected visual acuity remained at the preoperative level in 22 eyes (74%), improved in five eyes (16%), and declined in three eyes (10%). At the end of the follow-up period, uncorrected visual acuity was 20/50 or better in three of 30 treated eyes (10%) and 20/100 or better in 25 of 30 treated eyes (83.3%). No intraoperative complications were observed, but the following postoperative complications were seen in seven of 30 (23.2%) eyes: four eyes (13.3%) developed irregular astigmatism, one eye (3.3%) had poor night vision, and two eyes (6.6%) had irregularities in Bowman's membrane. The operation was repeated with homoplastic material in one of the two eyes with Bowman's membrane irregularities after six months, because of central alterations in Bowman's membrane.
Adolescent↗
[Low-molecular weight sodium hyaluronate in the treatment of tear film changes and of dry eye].
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Adolescent↗
Nocardia keratitis: a case report.
PURPOSE: To describe a case of Nocardia keratitis resistant to 2% amikacin, with a toxic-allergic reaction to fortified topical 5% amikacin, and recurrence of the infection with topical corticosteroids. METHODS: Nocardia was diagnosed from a smear and positive culture and identified as Nocardia asteroides by gas chromatography and quantitative fatty acid analysis using the Microbial Identification System. Treatment was started with topical 2% amikacin, which was subsequently raised to 5% because of clinical resistance. RESULTS: A toxic-allergic reaction was observed after 5% amikacin so the drug was discontinued and commercially available drugs combining 1% chloramphenicol, 0.5% tetracycline, and 18 mil IU colistin with 0.3% ofloxacin were given. These were well tolerated and the infection improved quickly. After 1 month the antibiotics were discontinued and topical 0.1% clobetasone was given to reduce scar formation. The infection recurred after 1 week but responded to 3 months of the previous antibiotic combination and its sensitivity was checked with the Epsilometer test. CONCLUSIONS: Nocardia keratitis may not respond to 2% topical amikacin and fortified topical 5% amikacin may cause a strong toxic-allergic reaction. A commercially available combination of chloramphenicol, tetracycline, and colistin, with ofloxacin, may be effective but the treatment must be continued for several months. Topical steroids should only be used with considerable caution since they can lead to relapse of the infection.
Adult↗