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Biomedical subjects

S Milazzo

Publications and source records attributed to S Milazzo.

At least 19 recordsLinked to original sources

Laetrile treatment for cancer.

BACKGROUND: Laetrile is an unconventional therapy which has been used illegally for decades by cancer patients who together with some alternative therapists claim its effectiveness as an anti-cancer treatment. It has been often referred to as amygdalin, although the two are not the same. OBJECTIVES: The aim of this review was to assess the alleged anti-cancer effect and the possible harms of Laetrile as a sole or adjunctive therapy in cancer treatment. SEARCH STRATEGY: We searched The Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE (from 1951); EMBASE (from 1980); Allied and Complementary Medicine (AMED), Scirus, CancerLit, CINAHL (all from 1982); CAMbase (from 1998); the MetaRegister; the National Research Register and our own files. No language restrictions were imposed. SELECTION CRITERIA: Randomized clinical trials (RCTs) and non randomized controlled clinical trials (non-RCTs). DATA COLLECTION AND ANALYSIS: Two reviewers independently assessed trials for inclusion in the review, assessed study quality and extracted data. MAIN RESULTS: No RCTs or non-RCTs were found, so no abstraction of outcome data could be performed in this systematic review AUTHORS' CONCLUSIONS: The claim that Laetrile has beneficial effects for cancer patients is not supported by data from controlled clinical trials. This systematic review has clearly identified the need for randomised or controlled clinical trials assessing the effectiveness of Laetrile or amygdalin for cancer treatment.

Amygdalin↗

[Acute spontaneous corneal hydrops in a patient with pellucid marginal corneal degeneration].

Pellucid marginal corneal degeneration (PMCD) is an ectatic corneal disorder characterized by a peripheral, noninflammatory band of thinning of the inferior cornea. This condition often is misdiagnosed with keratoconus, with which it shares several clinical, videotopographic, and histologic aspects. Furthermore, as with keratoconus, hydrops and spontaneous corneal perforation can occur. We report the case of a 56-year-old man with confirmed PMCD, emphasizing the diagnostic approach, the disease follow-up, and its complication in spontaneous acute corneal hydrops. Finally, regarding this case, authors collect the clinical and videotopographic characteristics of PMCD and discuss the different therapeutic options.

Acute Disease↗

Noninvasive ratio indexes to evaluate fibrosis staging in chronic hepatitis C: role of platelet count/spleen diameter ratio index.

OBJECTIVES: Noninvasive evaluation of fibrosis is an on-going effort in the management of chronic hepatitis C. This study was planned to noninvasively evaluate fibrosis staging. DESIGN: We evaluated the biochemical, functional [aminopyrine breath test (ABT)] and ultrasonographic variables of 75 chronic hepatitis C patients. RESULTS: Clinical [body mass index (BMI)], biochemical [aspartate aminotransferase (AST), alanine aminotransferase (ALT) and platelets (PLT)] and ratio indexes, together with the ABT, showed a higher relationship with fibrosis: initial (score 2) fibrosis: BMI (24+/-2 vs. 26+/-2, P=0.0007), AST (56+/-36 vs. 88+/-65, P=0.0159), ALT (92+/-54 vs. 139+/-108, P=0.0290), PLT (220+/-64 vs. 173+/-61, P=0.0007), PLT/spleen diameter ratio (PLT/SPD) (2133+/-786 vs. 1540+/-681, P=0.0003), AST/platelet count ratio index (APRI) (0.80+/-0.87 vs. 1.51+/-1.47, P=0.0010), ABT%d/h30 min (10.8+/-4.5 vs. 7.6+/-3.8, P=0.0007), ABT%d/cum120 min (8.9+/-3.3 vs. 6.5+/-3.1, P=0.0007). Considering the differences between fibrosis score 2 and 3 patients, BMI, ABT and PLT/SPD ratio proved to be statistically significant. Multivariate stepwise analysis (with and without BMI) identified two models for distinguishing between initial and evident fibrosis: Model 1: -0.569+(BMIx0.107)+(APRIx0.169)-(PLT/SPDx0.304), and Model 2: 2.376+( APRIx0.152)-(ABTd/h30x0.043)-(PLT/SPDx0.249). These models showed concordance in identifying or ruling out evident fibrosis in 76% and 78.7% of the patients respectively. The PLT/SPD ratio also showed 78.7% concordance with the histological score. CONCLUSION: These results suggest that noninvasive evaluation of fibrosis in chronic hepatitis C may be considered an effective tool thanks to the use of an inexpensive, reproducible ratio index.

Adult↗

[New treatment for orbital non-Hodgkin's lymphoma: 2 cases treated with rituximab].

INTRODUCTION: Orbital non-Hodgkin's lymphoma is a rare tumor whose diagnosis is often difficult. Treatment of latent lymphoma have been changing because of progress in immunotherapy. OBSERVATION: We report two patients treated with rituximab (antibody anti-CD20). Two women, 50 and 59 years old, presented low-grade, IE-stage lymphoma. One was conjunctival MALToma, the other was orbitopalpebral, type A, of WFC classification, follicular, with small cells. Immunohistochemistry showed a diffused marking for Ac anti-CD20. Both patients received intravenous rituximab as a first treatment in December 2000, 375 mg/m2, four injections per week. We did not note any major undesirable effects. Both have been in complete remission for 4 years. These patients continue to be followed up. DISCUSSION: Rituximab's efficacy has been proved mainly in follicular LMNH or in recurrent forms. The recurrence may be more frequent in MALT lymphoma. This medical treatment has low hematologic toxicity. CONCLUSION: Rituximab offers an alternative for low-grade lymphoma treatment that is well tolerated by the patient.

Antibodies, Monoclonal↗

[Traumatic carotid-cavernous sinus fistula: a case study].

The diagnosis of carotid-cavernous sinus fistula is based on clinical findings and must be confirmed and detailed by CT scan and arteriography. If the treatment, based on embolization, is not undertaken in the emergency room, visual complications or even death may result. We give an example of a direct post-traumatic carotid-cavernous sinus fistula, stressing its clinical characteristics (ophthalmoplegia) and treatment: the advantages of arteriography and of embolization methods (most often by detachable balloon or coils, through arteries or veins).

Adult↗

[Orbital non-Hodgkin's lymphoma: a retrospective study of 22 patients].

INTRODUCTION: Although the number of non-Hodgkin's lymphoma (NHL) cases continues to grow throughout the world, orbital NHL is still a rare tumor that is difficult to diagnose. The objective of our study was to analyze the different orbital NHLs diagnosed in our Ophthalmology Department during the last 20 years. MATERIAL AND METHODS: [corrected] We conducted a retrospective study of conjunctive-orbital lymphomas diagnosed in the Amiens Ophthalmology Department between 1982 and 2002. The pathological reports of 22 cases were investigated, notably the mode of onset, the clinical and radiological description, the diagnostic mode, pathological results, and the type of treatment provided for these tumors. RESULTS: Every NHL was type B. They were for the most part low grade in terms of malignancy, isolated, primitive, orbital and inactive. DISCUSSION: Insidious, slow-growing lesions are often found, and biopsy can be difficult. This may explain delayed diagnosis. The first differential diagnosis is inflammatory pseudotumor. Only a good biopsy can confirm the diagnosis of NHL. CONCLUSION: New immunohistochemistry and genetic diagnostic methods make it increasingly possible to screen for NHL, even if the clinical history can be misleading. Moreover, treatments that are more and more precisely targeted to the immunohistochemical type of NHL seem to be giving very promising results. Several studies are ongoing.

Aged↗

[Post-traumatic endocapsular blood effusion].

A rare complication after extracapsular surgery of the cataract, blood effusion is often a fortuitous discovery when a drop in visual acuity occurs. The subject reported herein is a 76-Year-old patient who presented an endocapsular blood effusion with no liquid level 1 Year after the extracapsular surgery of the cataract, discovered while examining a decrease in visual acuity. Questioning led to the discovery of eye trauma due to Nd: YAG laser posterior capsulotomy 3 Months before, which had progressed spontaneously and favorably for 2 Months, with a reduction of the effusion and better visual acuity. The bleeding seems to have come from a vascular injury due to a direct contusion, with blood possibly coming from the ciliary body, the iridocorneal angle, or the vitreous. The liquid effusion may have been caught at the back by the implant and enclosed in the area located between the capsular bag and the anterior hyaloid, without intravitreous diffusion. Most of reported cases in the literature discuss observations made on an intact posterior capsule, which appeared during or after close surgery. The treatment was simple supervision. Some Authors propose a Nd: YAG laser capsulotomy in case resorption is too slow.

Aged↗

Scleral ectasia as a complication of deep sclerectomy.

Nonpenetrating deep sclerectomy is a filtration surgical technique to treat glaucoma. A 12-year-old girl presented with chronic arthritis complicated with glaucoma secondary to a chronic uveitis. A sclerectomy without a collagen implant was performed for uncontrollable glaucoma with deterioration in visual function. Three weeks later, the patient had a rise in intraocular pressure and a scleral ectasia on the sclerectomy. The eye showed an area of scleral ectasia in the bleb as well as iris adhesion. Partial resection of the bleb after iris detachment led to poor anatomic and IOP results. The indications for deep sclerectomy must be carefully considered, especially in patients at a young age with this type of glaucoma.

Arthritis, Juvenile↗

[Temporo-spheno-orbital meningioma. An unusual cause of exophthalmos. Report of one case].

We report the case of a 48-year-old woman with no prior medical history who developed headache and unilateral exophthalmos for 6 months. Clinical and radiographic findings detailed the intracranial extension of a temporo-spheno-orbital meningioma. Histological diagnosis was established after curative neurosurgery. This case recalls the characteristic features of temporo-spheno-orbital meningiomas.

Exophthalmos↗

Wagner vitreoretinal degeneration with genetic linkage refinement on chromosome 5q13-q14.

BACKGROUND: It has been previously described that Wagner disease is linked to chromosome 5q13-q14. This study was carried out to describe the ophthalmological aspects and report the results of genetic linkage analysis in a large pedigree affected by Wagner disease. METHODS: Fourty members of one same family agreed to be examined. RESULTS: Twenty patients presented vitreoretinal degeneration in both eyes without any extra-ocular abnormalities. In young patients, visual acuity was usually normal after correction of frequent mild myopia. Presenile cataracts progressed by the third decade and required removal for visual rehabilitation. The primary disorder involved an abnormal vitreous. A few avascular vitreous bands were usually the only optical feature in the mostly empty vitreous cavity. A circumferential vitreous condensation formed in contact with the retina on many spots. Less common retinal findings included retinal detachment, abnormal retinal pigmentation, progressive atrophy of the RPE simulating choroideremia and lattice degeneration. Genetic analysis revealed a highly significant linkage (lod score >5.0) between the disease and 10 markers of the chromosome 5q13-q14 region. Two recombination events allowed us to refine the linked interval to 20 cM between the D5S650 and D5S618 markers. CONCLUSION: Ophthalmological aspects of Wagner's disease appear to progress with age. Regular ophthalmological examination is important for detecting retinal abnormalities. The gene involved in Wagner's disease lies in a 20 cM interval on chromosome 5q13-q14.

Adolescent↗

[Congenital pit of the optic disk in indocyanine green].

PURPOSE: Etiopathogeny of serous retinal detachment (SRD) in optic pits remains a mystery. Several hypotheses have been proposed that lead to different treatments based on the possible mechanisms which explain the occurrence of SRD. The literature data about fluorescein angiography mainly concern the angiographic aspects of the optic pit itself, and seldom the SRD. We have examined these fluorescein angiographic aspects of the SRD. Indocyanine cardiogreen video-angiography gives new information which question the last etiologic hypothesis. METHODS: Nine patients underwent a fluorescein angiography when the SRD was discovered. Indocyanine cardiogreen was performed in four patients. RESULTS: In 8 cases there was hyperfluorescence on the optic pit. In 7 cases in the peripapillar space of the SRD. In one of these cases, there was a leakage on the temporal margin of the optic nerve. In 8 cases in the SRD: we noticed a late minimal hyperfluorescence in the SRD but it already existed in the early angiogram. The SRD became hyperfluorescent in arterio-veinous retinal phase. In late phases we noticed a well-demarcated area of hyperfluorescence. CONCLUSION: These investigations have revealed a permeation problem on the blood-outer retinal barrier of the peripapillar space and above all from the edge of optic pit. This can have a prognosis value for SRD. The hyperfluorescence in SRD remains an enigma and does not allow, as we thought before, to confirm one of the etiopathogenic hypotheses. A better acknowledge of indocyane cardiogreen angiographic semiology will allow us to explain these aspects in the future.

Adolescent↗

[Changes in intraocular pressure during anesthesia with intratracheal intubation or laryngeal mask].

OBJECTIVE: To compare the effects of the laryngeal mask airway (LMA), and the tracheal tube (TT) insertion on intra-ocular pressure (IOP) in eye surgery. STUDY DESIGN: Prospective non-randomized study. PATIENTS: Eighty patients scheduled for eye surgery under general anaesthesia were allocated into either a LMA group (n = 37) or a TT group (n = 43). METHODS: After induction of anaesthesia with propofol, vecuronium and phenoperidine, either a TT or a LMA were inserted. IOP, heart rate (HP) and mean arterial pressure (MAP) were measured before (TO) and after induction (T1), after TT or LMA insertion (20 s:T2, 6 min:T3), and before extubation (T4). RESULTS: The HR, MAP and IOP increased significantly at T2 (compared to T1 but not to T0) in the TT group, for a short time, whereas no significant changes occurred in the LMA group. CONCLUSION: LMA insertion does not elicit significant haemodynamic or IOP changes. Conversely, the TT increases HR, MAP and IOP. These changes can be deleterious in case of emergency surgery for perforating eye injuries. The LMA can be recommended as an alternative to TT in eye surgery, provided security rules are followed, because of the risk of displacement of LMA during surgery.

Adult↗

Long-term follow-up of three-piece, looped, silicone intraocular lenses.

PURPOSE: To present long-term follow-up of silicone lens implantation. SETTING: Clinique Ophtalmologique, Centre Saint-Victor, Amiens, Cédex, France. METHODS: In this prospective study, we followed 111 eyes consecutively operated on from March 1988 to July 1989. Foldable silicone intraocular lenses (IOLs) were implanted in 107 eyes and poly(methyl methacrylate) (PMMA) IOLs in 4 eyes. The eyes with PMMA lenses were excluded from the study. RESULTS: After a follow-up of 3 years (average 20 months), 13.7% of eyes with posterior capsule opacification (PCO) required a neodymium:YAG (Nd:YAG) laser capsulotomy. In the group with longer follow-up (average 57 months), 40.6% required Nd:YAG capsulotomy. The majority of capsulotomies were performed in the fourth year after surgery. The PCO rate was the same whether the IOL was placed in the sulcus or in the capsular bag (51.5 versus 48.5%). The Nd:YAG treatment caused pitting of the silicone in most cases, with no effect on visual acuity. We did not observe other serious complications such as retinal detachment, endophthalmitis, or silicone discoloration. There was no visual acuity below 20/35. CONCLUSIONS: In this series, the silicone IOLs were compatible with phacoemulsification and did not have a higher rate of complications than has been reported for PMMA IOLs.

Aged↗

Alterations to the AcrySof intraocular lens during folding.

PURPOSE: To determine the frequency and cause of scratches or marks on the AcrySof intraocular lens (IOL). SETTING: Centre SaintVictor, Amiens Cédex, France. METHODS: In a clinical study, an AcrySof IOL was implanted in four eyes using a McDonald-Livernois forceps. In an experimental study, 50 sterile AcrySof IOLs were folded under a surgical microscope by one person; 40 were folded with a modified Steinert forceps and 10, with a modified Buratto forceps. RESULTS: Three IOLs implanted in the clinical study had scratches, marks, or both. These were noted during surgery but were not significant enough to justify explantation. They had no effect on recovery of vision. Of the 50 IOLs studied microscopically, 18 showed no defects; 32 had some alterations that were difficult to assess because they were minimal or because more than one alteration appeared on the same lens. CONCLUSION: AcrySof IOLs are more fragile than silicone IOLs, although the alterations caused by folding did not affect visual acuity in this study. To avoid complications, the lens must be folded on the 6 to 12 o'clock axis and the haptics inserted one right after the other.

Acrylates↗

Intraocular lens implantation in eyes with Fuchs' heterochromic iridocyclitis.

PURPOSE: To evaluate the results of cataract surgery with intraocular lens (IOL) implantation in eyes with Fuchs' heterochromic iridocyclitis. SETTING: Saint-Victor Hospital, Amiens, France. METHODS: We reviewed the charts of 93 patients (94 eyes) with heterochromic iridocyclitis who had cataract extraction and IOL implantation by the same surgeon. In six patients, the IOL was placed in the anterior chamber; 9 received Binkhorst four-loop IOLs sutured at the 12 and 6 o'clock positions, and 79 received posterior chamber IOLs, 15 in the sulcus and 64 in the capsular bag. Follow-up was from 6 months to 10 years (mean 41 months). RESULTS: Precipitates on the IOL surface and white keratic precipitates were detected in 65.5% of eyes. Most eyes had minimal anterior segment activity. No severe uveitis was observed. The major problem, observed in 12.3% of the patients, was glaucoma. Best corrected postoperative visual acuity was 20/40 or better in 76.6% of eyes. CONCLUSION: Eyes with heterochromic iridocyclitis responded well to cataract extraction with IOL implantation. The restoration of satisfactory binocular vision justifies IOL implantation in patients with Fuchs' unilateral syndrome.

Adolescent↗