- Bilateral Ulcerative Keratitis Associated With Afatinib Treatment for Non-Small-Cell Lung Carcinoma. [Journal Article]
- CCornea 2018 Nov 08
- CONCLUSIONS: To the best of our knowledge, this is the first case in the literature that reports afatinib-related ulcerative keratitis. Careful monitoring for signs of ocular adverse events is recommended during treatment with afatinib for non-small-cell lung carcinoma.
- Swollen and bloodshot eye following headache. [Journal Article]
- AJAm J Emerg Med 2018 Nov 07
- A ruptured cavernous carotid aneurysm (CCA) with carotid cavernous fistula can appear as a benign headache but progress to a swollen and bloodshot eye overnight. A 66-year-old woman visited emergency...
A ruptured cavernous carotid aneurysm (CCA) with carotid cavernous fistula can appear as a benign headache but progress to a swollen and bloodshot eye overnight. A 66-year-old woman visited emergency department with sudden onset of pain behind her left forehead and vomiting. She was treated for a migraine-like headache and discharged. She presented again on the next day with a persistent headache and a swollen left eye with blurred vision. An ophthalmologic examination revealed erythema of the left lid and chemosis at the temporal and lower bulbar conjunctiva. A cranial nonenhanced computed tomography (CT) scan had been performed at her previous visit. The scan exhibited a nodular mass lesion involving the left cavernous sinus. CT angiography was subsequently used to determine that the lesion was a giant aneurysm in the left cavernous internal carotid artery, causing enlargement of the left ophthalmic veins. The symptoms of her left eye rapidly progressed to severe chemosis, edematous change over periocular region, and limited movements after 8 h. The patient received emergent lateral canthotomy and inferior cantholysis to avoid acute orbital compartment syndrome and was subsequently treated with stent-assisted coil embolization. A ruptured CCA is an urgent condition that requires rapid assessment of both cranial vascular and ocular lesions. A history of sudden onset headache with a nonpainful acute unilateral red eye may serve as a clue to prompt additional diagnostic studies and ophthalmologist evaluation. Adequate radiological studies and early endovascular intervention can reduce the likelihood of permanent ocular injury and vision impairment.
- Treatment of osteoarthritis of the elbow with open or arthroscopic debridement: a narrative review. [Journal Article]
- BMBMC Musculoskelet Disord 2018 Nov 10; 19(1):394
- CONCLUSIONS: This narrative review could not provide an insight on which surgical procedure is superior to the other due to the poor orthopedics literature. However, from the data we obtained the open and arthroscopic debridement procedures seem to be safe and effective in the treatment of elbow OA. The optimal surgical intervention for the treatment of symptomatic elbow OA should be determined depending on patients' conditions.
- Atypical presentation of a solid-variant orbital aneurysmal bone cyst with a literature review. [Journal Article]
- NNeurochirurgie 2018 Nov 06
- CONCLUSIONS: This case report details a rare presentation of ABC (solid-variant presenting outside of the vertebrae/long bones) with discussion concerning possible treatment modalities and guidance for follow-up.
- The combination of strip meniscometry and dry eye-related quality-of-life score is useful for dry eye screening during health checkup: Cross-sectional study. [Journal Article]
- MMedicine (Baltimore) 2018; 97(43):e12969
- Strip meniscometry (SM) is a new method for quantification of tear volume using meniscometry strips inserted into the tear meniscus for 5 seconds. The dry eye (DE)-related quality-of-life score (DEQS...
Strip meniscometry (SM) is a new method for quantification of tear volume using meniscometry strips inserted into the tear meniscus for 5 seconds. The dry eye (DE)-related quality-of-life score (DEQS) questionnaire comprises 15 questions regarding bothersome ocular symptoms and their impact on daily life. These 2 examinations require a relatively short time and are appropriate as screening tests. We evaluated the sensitivity and specificity of SM and DEQS for screening for DE syndrome during general health checkup.This study included 333 right eyes from 333 soldiers (331 men, 2 women; mean age, 42.8 ± 8.8 years) who underwent health checkups at the Yokosuka Medical Squadron between November and December 2013. We administered the DEQS questionnaire to the subjects. The fluorescein tear film break-up time and fluorescein and rose bengal staining scores were evaluated. A positive outcome was considered when DEQS >15 and SM scores <5 mm. We compared DEQS and SM between a DE group, suspected-DE group and normal group.Thirty-four (11%) soldiers were diagnosed with definite DE based on the Japanese DE diagnostic criteria. The sensitivities of SM, DEQS, and SM combined with DEQS for definite DE were 71%, 79%, and 59%, respectively, whereas the corresponding specificities were 85%, 91%, and 97%, respectively. None of the enrolled subjects experienced complications such as eye pain or discomfort, except for 1 soldier (0.003%) with conjunctivochalasis, who experienced irritation upon SM.The results of our study indicate that the combination of SM and DEQS is useful for the detection of DE with high sensitivity and specificity during routine health check-up.
- Dual enkephalinase inhibitor (DENKI) PL265: a novel topical treatment to alleviate corneal pain and inflammation. [Journal Article]
- PAINPain 2018 Oct 17
- Ocular pain is a core symptom of inflammatory or traumatic disorders affecting the anterior segment. To date, the management of chronic ocular pain remains a therapeutic challenge in ophthalmology. T...
Ocular pain is a core symptom of inflammatory or traumatic disorders affecting the anterior segment. To date, the management of chronic ocular pain remains a therapeutic challenge in ophthalmology. The main endogenous opioids (enkephalins) play a key role in pain control but exhibit only transient analgesic effects due to their rapid degradation. The aim of the present study was to explore the anti-nociceptive and anti-inflammatory effects of topical administration of PL265 (a dual enkephalinase inhibitor) on murine models of corneal pain. On healthy corneas, chronic PL265 topical administration did not alter corneal integrity nor modify corneal mechanical and chemical sensitivity. Then, on murine models of corneal pain, we showed that repeated instillations of PL265 (10 mM) significantly reduced corneal mechanical and chemical hypersensitivity. PL265-induced corneal analgesia was completely antagonized by naloxone methiodide, demonstrating that PL265 antinociceptive effects were mediated by peripheral corneal opioid receptors. Moreover, flow cytometry (quantification of CD11b+ cells) and in vivo confocal microscopy analysis revealed that instillations of PL265 significantly decreased corneal inflammation in a corneal inflammatory pain model. Chronic PL265 topical administration also decreased Iba1 and neuronal injury marker (ATF3) staining in the nucleus of primary sensory neurons of ipsilateral trigeminal ganglion. These results open a new avenue for ocular pain treatment based on the enhancement of endogenous opioid peptides' analgesic effects in tissues of the anterior segment of the eye. Dual enkephalinase inhibitor PL265 appears to be a promising topical treatment for safe and effective alleviation of ocular pain and inflammation.
- Color Doppler imaging evaluation of blood flow parameters in ophthalmic and posterior ciliary arteries and optic nerve diameter in chronic optic neuritis in multiple sclerosis patients. [Journal Article]
- MSMult Scler Relat Disord 2018 Oct 03; 27:195-199
- CONCLUSIONS: These results indicate that there is a significant relation between eye involvement and increased optic nerve diameter in MS patients with chronic ON. While, there were no significant relations in EDV, PSV, RI and PI in PCA and OA comparing two groups.
- Preoperative Intravenous Ketorolac Safely Reduces Postoperative Pain in Levator Advancement Surgery. [Journal Article]
- OPOphthalmic Plast Reconstr Surg 2018 Nov 05
- CONCLUSIONS: In the setting of levator advancement surgery, IVK results in a dramatic reduction in self-reported pain score immediately after surgery and on postoperative day 1 and the requirement for opioid analgesics. This medication may be safely utilized for ptosis repair.
- The Impact of Fibromyalgia in Spondyloarthritis: From Classification Criteria to Outcome Measures. [Review]
- FMFront Med (Lausanne) 2018; 5:290
- The term spondyloarthritis (SpA) encompasses a broad clinical spectrum characterized by chronic inflammatory conditions affecting the sacroiliac joints, the spine but also peripheral joints and tendo...
The term spondyloarthritis (SpA) encompasses a broad clinical spectrum characterized by chronic inflammatory conditions affecting the sacroiliac joints, the spine but also peripheral joints and tendons and being additionally associated with the involvement of organs, such as bowel, eye and skin (1). Musculoskeletal pain is a key symptom in SpA. However, although low back pain and/or joint pain are characteristic for SpA, undifferentiated pain at different enthesial sites may also be a concomitant or even the first clinical presentation in some patients (2). In addition, fatigue is another important symptom often reported by patients with SpA, which substantially affects the quality of life (QoL) (3). Fibromyalgia (FM) is the most common diagnosis in patients complaining of chronic diffuse pain with fatigue and may occur alone or in association with chronic inflammatory diseases (4). The prevalence of FM ranges from 2 to 8% in the general population and it can reach up to over 50% in patients with other rheumatic and musculoskeletal diseases (RMDs) (5-7). FM has been identified as the most disabling RMD, based on the patients' perception that their medical condition is not properly recognized (8). This is also due to the poor knowledge about its pathogenesis, and therefore the lack of reliable biomarkers reveals a major unmet need requiring to be addressed in further research studies. Over the last decade, an increasing body of evidence described the impact of FM in SpA highlighting the pitfalls for correct classification, appropriate differential diagnosis and assessment of outcome measures in both conditions. The purpose of this review is to provide an overview of currently available data with regard to the coexistence and reciprocal features of FM and SpA.
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- Comparative Evaluation of Mucosal Vibrator with Topical Anesthetic Gel to reduce Pain during Administration of Local Anesthesia in Pediatric Patients: An in vivo Study. [Journal Article]
- IJInt J Clin Pediatr Dent 2018 Jul-Aug; 11(4):261-265
- CONCLUSIONS: The result shows that mucosal vibration can be used as an effective means to reduce the intensity of pain during local anesthetic injection in dentistry.How to cite this article: Tandon S, Kalia G, Sharma M, Mathur R, Rathore K, Gandhi M. Comparative Evaluation of Mucosal Vibrator with Topical Anesthetic Gel to reduce Pain during Administration of Local Anesthesia in Pediatric Patients: An in vivo Study. Int J Clin Pediatr Dent 2018;11(4):261-265.