Purpose: To study epidemiology and clinical findings of cataract in HIV+ patients.
Methods: A total of 32 HIV+ patients, 11 with uveitis/retinitis before surgery and 21 without, mean follow-up 44.9 ± 36.6 months, and 114 HIV- patients, 57 with uveitis/retinitis before surgery and 57 without, were retrospectively compared.
Results: Visual acuity improved in all HIV+ patients (p < 0.001), who were younger (p = 0.01) and more frequently males (p = 0.027). HIV+ patients with uveitis prior surgery improved less (p = 0.046) than HIV- (p < 0.001); their anterior chamber inflammation was similar to baseline. Male sex (p = 0.005), younger age (p < 0.001), dyslipidaemia (p = 0.058), HBV+ (p = 0.037), and unilateral cataract (p = 0.001) were more frequent in HIV+ patients with senile cataract, but they showed the same postoperative course as HIV- patients.
Conclusion: Cataract surgery in HIV+ patients is safe and effective. Uveitis prior to surgery did not significantly affect the postoperative course. Systemic comorbidities are more frequent in HIV+ patients with senile cataract than in HIV- subjects. 相似文献
During skeletal development the two ossification centers of the odontoid process are separated from the corpus of the axis by a subdental synchondrosis. This synchondrosis is thought to close and disappear spontaneously in adolescence although this has never been studied in detail. The basis of the dens is of clinical relevance as type II dens fractures are located here. To characterize the morphological architecture of the axis with particular attention to the subdental synchondrosis, the complete axis was harvested from thirty age-matched and gender-matched patients of the three different age groups at autopsy. The subdental synchondrosis and the bone structure of the dens, the basis of the dens and the body of C2 were analyzed by radiography, histology and quantitative histomorphometry. At the macroscopic level the persistency of the subdental synchondrosis in the adult cervical spine was detected in 87% (26 of 30) of the specimens. Histomorphometry revealed a residual disc blastema with an average size of 25.8% of the sagittal depth of the basis of the dens at this level. Bony integration of the synchondrosis was poor throughout all ages. Histologically a cartilaginous matrix composition of the subdental synchondrosis persisted throughout all groups. The trabecular microarchitecture demonstrated a significant reduction of bone volume and trabecular number as well as an increased trabecular separation within the basis of the dens as compared to the corpus or the dens of C2. This histomorphometric data regarding a poor integration of the synchondrosis into the trabecular network and the reduced bone mass within the basis of the dens might offer a previously underestimated explanation for the occurrence of type II dens fractures and their association with pseudoarthrosis, respectively.Matthias Gebauer and Christian Lohse contributed equally to this study and therefore share first authorship. 相似文献
Nervensch?digungen als Begleitverletzungen bei Monteggia-Frakturen sind selten und betreffen meistens den N. radialis. üblicherweise
kommt es bei frischen Frakturen zu einer spontanen neurologischen Remission, nachdem der Radiuskopf wieder reponiert wurde.
Im vorliegenden Fall erlitt ein heute 33-j?hriger Mann eine Parese des N. interosseus posterior 27 Jahre nach einer Monteggia-Fraktur,
wobei der Radiuskopf in luxierter Stellung verblieb. Nach einem Bagatelltrauma am Handgelenk beim Federballspielen kam es
zu einer L?hmung der Handgelenk- und Fingerstreckmuskulatur. Eine konservative Behandlung mittels intensiver Physiotherapie
blieb auch nach 4 Monaten erfolglos. Daraufhin wurde der Nerv exploriert. Der Profundusast zeigte sich dabei narbig adh?rent
im Bereich einer beengenden und verdickten Frohse-Arkade. Anschlie?end erfolgte eine Narbenl?sung sowie Spaltung der Arkade,
der Radiuskopf wurde im ursprünglichen verrenkten Zustand belassen. Eine v?llige Erholung des l?dierten Nerven war 9 Monate
postoperativ erreicht. 相似文献
We review evidence suggesting that deaf speakers do not move their articulators toward the following open posture throughout closure and report results from a preliminary cinefluorographic study. Two prelingually deaf and two hearing speakers produced two different strings of alternating heterogeneous monosyllables as though speaking in time with a metronome (the so-called P-center task). Events traditionally associated with vowel production appeared evenly timed throughout the productions, and, in general, the deaf speakers performed similarly to the hearing speakers. We relate the results to Fowler's (1983) interpretation of the P-center phenomenon as an indicant of continuous vowel production. 相似文献
Aim There is a controversy as to whether dyslexic children present visuo-motor disabilities such as vergence and accommodative
problems assessed with orthoptic tests. The purpose of this study is to re-examine this issue in a large population of children.
Methods Extensive orthoptic evaluation was made in 57 dyslexic and 46 non-dyslexic (“normal”) age-matched children. Convergence and
divergence capacities were evaluated at two distances (30 cm and 400 cm).
Results Binocular vision measured with stereo-acuity tests was normal in dyslexics. In contrast, the near point of convergence was
significantly more remote in dyslexics; most importantly, divergence at both far and near distance was significantly more
reduced in dyslexics (median value 4 pD and 10 pD, respectively, at far and near) than in “normals” (median value 6 pD and
12 pD, at far and near).
Conclusion The existence of the divergence deficit at far distance indicates the presence of deficit of divergence per se, independently
from convergence and accommodation relaxation. This result is novel and corroborated by physiological studies indicating distinct
control of convergence and divergence, both at the cortical and subcortical premotor level. We conclude that vergence deficits
are frequently present in dyslexics, and that dyslexics should be re-educated; training should address distinctively convergence
and divergence subsystems. 相似文献
Background The atopy patch test (APT) is no longer an experimental method; it is increasingly being used as a standard diagnostic tool for the characterization of patients with aeroallergen- and food-triggered disorders. Some technical aspects of this test still remain to be answered. We aimed to study the reproducibility of this test over time in the general child population. Methods In a general population of 118 children, we investigated the reproducibility of duplicate APTs with four food allergens in their native form, which were repeated at set intervals from the first test: 7 days (group 1), 14 days (group 2), and 21 days (group 3). Results We observed very poor reproducibility on both sides of the back in all three studied subgroups. The reproducibility rates and Cohen's κ values did not improve when we did not consider the side of the back. There were no differences in the prevalence of atopy between the subjects with reproducible and nonreproducible APT results. All three groups studied showed no difference in the prevalence rates of atopy. There was no relationship between APT and skin prick test positivity for the same allergen. Questionnaire-derived data about previous food-related reactions did not help in the evaluation of the doubtful nonreproducible APT results with food allergens. Conclusions Our results show that the reproducibility of food APTs is poor and unsatisfactory over time, and there is an urgent need for the development of optimal, stable, and good-quality APT testing substances. 相似文献
Rupture of the Achilles tendon is typically associated with sportive activities with increasing tendency; it occurs most commonly in the third to fourth decade of life with a male-to-female ratio of 5–10:1. Ruptures are caused predominantly by a sudden, unexpected overextension of the tendon while direct trauma is less frequent. The recommended treatment of the injury remains controversial. In Germany, due to the good functional results, the open surgical repair represents the standard therapy since many years. The open suture technique offers the advantage of a lower re-rupture rate but is associated with the risk of wound-related complications including infection. By percutaneous suture techniques a significant decrease in the rate of infections and complications in wound healing could be achieved by minimal-access with reduced soft tissue trauma; on the other hand an increased rate of lesions of the sural nerve is reported. Dynamic imaging assessment of ultrasound or MRI allows a more accurate localisation of the ruptured ends of the tendons which is the prerequisite for the non-operative primary functional treatment of Achilles tendon ruptures. This conservative treatment regime is recommended when adaptation of the ends of the ruptured tendon is possible in 20° plantar flexion of the foot. Moreover, the desired level of daily activity and the patients’ degree of compliance has to be considered. Operative management should be avoided in the elderly patient or patients with risk factors like immunosuppressive therapy, diabetes mellitus, steroid use or failure to comply. 相似文献