scholarly journals Orbital Apex Syndrome due to Orbital Mucormycosis after Teeth Infection: A Successful Case Report

2021 ◽  
pp. 110-115
Author(s):  
Gonçalo Godinho ◽  
Isabel Abreu ◽  
Gonçalo Alves ◽  
Ricardo Vaz ◽  
Vitor Leal ◽  
...  
Keyword(s):  
Fungal Infection ◽  
Survival Rates ◽  
Health Condition ◽  
Histopathological Diagnosis ◽  
Orbital Apex ◽  
Orbital Apex Syndrome ◽  
Successful Case ◽  
General Health Condition ◽  
One Year ◽  
Antibiotic Agents

Rhino-orbital-cerebral mucormycosis is a severe and rapidly progressive fungal infection associated with low survival rates. Early diagnosis and proper management are mandatory. We report the case of a 20-year-old female with diabetic ketoacidosis and teeth infection, who presented with sudden orbital apex syndrome. Several surgical procedures were necessary to provide a definite histopathological diagnosis of the fungal infection. Ultimately, given the progressive aggravation of the infection and the ineffectiveness of antifungal and antibiotic agents, an orbital exenteration was performed. A mycobacteriological examination revealed a polymicrobial culture with <i>Mucorales</i>. One year after the initial presentation, the patient is alive and with a good general health condition.

scholarly journals The importance of mucormycosis infections on example of Rhino Orbital Cerebral Mucormycosis

2021 ◽  
Vol 75 ◽  
pp. 211-216
Author(s):  
Łukasz Pałka ◽  
Vivek Gaur
Keyword(s):  
Fungal Infection ◽  
General Health ◽  
Clinical Manifestations ◽  
Medical Intervention ◽  
Health Condition ◽  
Morbidity And Mortality ◽  
High Morbidity ◽  
Proper Treatment ◽  
General Health Condition ◽  
Immunocompetent Patients

Mucormycosis is an angioinvasive fungal infection, characterized by high morbidity and mortality and is strongly dependent on the patient’s general health condition, initial site of infection, and the time from diagnosis to treatment commencement. It has been reported that the occurrence of mucormycosis has increased rapidly, also among immunocompetent patients. Moreover, the rise in number is expected to continue. Among all clinical manifestations of mucormycosis, the rhino-orbital-cerebral type (ROCM) is the most common. The aim of this article is to increase the awareness of mucoral infections, especially ROCM, and to describe its first symptoms, as proper treatment requires immediate surgical and medical intervention.

Orbital apex syndrome secondary to nasopharyngeal carcinoma

2015 ◽  
Vol 4 (2) ◽  
pp. 177
Author(s):  
CS Sandhya ◽  
DMurali Krishna ◽  
C Jagannath ◽  
G Srinivas ◽  
K Radhika
Keyword(s):  
Nasopharyngeal Carcinoma ◽  
Orbital Apex ◽  
Orbital Apex Syndrome

MOLECULAR AND GENETIC SUBTYPES OF OVARIAN CANCER: PROSPECTS FOR FURTHER STUDIES

2019 ◽  
Vol 65 (1) ◽  
pp. 56-62
Author(s):  
Alisa Villert ◽  
Larisa Kolomiets ◽  
Natalya Yunusova ◽  
Yevgeniya Fesik
Keyword(s):  
Ovarian Cancer ◽  
Ovarian Carcinoma ◽  
Molecular Subtypes ◽  
Survival Rates ◽  
Consensus Algorithm ◽  
Histopathological Diagnosis ◽  
Low Grade ◽  
High Grade ◽  
Ovarian Carcinomas ◽  
Genetic Subtypes

High-grade ovarian carcinoma is a histopathological diagnosis, however, at the molecular level, ovarian cancer represents a heterogeneous group of diseases. Studies aimed at identifying molecular genetic subtypes of ovarian cancer are conducted in order to find the answer to the question: can different molecular subgroups influence the choice of treatment? One of the achievements in this trend is the recognition of the dualistic model that categorizes various types of ovarian cancer into two groups designated high-grade (HG) and low-grade (LG) tumors. However, the tumor genome sequencing data suggest the existence of 6 ovarian carcinoma subtypes, including two LG and four HG subtypes. Subtype C1 exhibits a high stromal response and the lowest survival. Subtypes C2 and C4 demonstrate higher number of intratumoral CD3 + cells, lower stromal gene expression and better survival than sybtype C1. Subtype C5 (mesenchymal) is characterized by mesenchymal cells, over-expression of N-cadherin and P-cadherin, low expression of differentiation markers, and lower survival rates than C2 and C4. The use of a consensus algorithm to determine the subtype allows identification of only a minority of ovarian carcinomas (approximately 25%) therefore, the practical importance of this classification requires additional research. There is evidence that it makes sense to randomize tumors into groups with altered expression of angiogenic genes and groups with overexpression of the immune response genes, as in the angiogenic group there is a comparative superiority in terms of survival. The administration of bevacizumab in the angiogenic group improves survival, while the administration of bevacizumab in the immune group even worsens the outcome. Molecular subtypes with worse survival rates (proliferative and mesenchymal) also benefit most from bevacizumab treatment. This review focuses on some of the advances in understanding molecular, cellular, and genetic changes in ovarian carcinomas with the results achieved so far regarding the formulation of molecular subtypes of ovarian cancer, however further studies are needed.

scholarly journals Orbital apex syndrome in COVID-19 patient, a case report

2021 ◽  
pp. 101006
Author(s):  
Masood Bagheri ◽  
Ahad Jafari ◽  
Sasan Jafari
Keyword(s):  
Case Report ◽  
Orbital Apex ◽  
Orbital Apex Syndrome

scholarly journals A review of malignant pleural mesothelioma in a large North East UK pleural centre

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Declan C. Murphy ◽  
Alexander Mount ◽  
Fiona Starkie ◽  
Leah Taylor ◽  
Avinash Aujayeb
Keyword(s):  
Malignant Pleural Mesothelioma ◽  
Survival Rates ◽  
Case Series ◽  
Pleural Mesothelioma ◽  
Retrospective Case ◽  
Pleural Thickening ◽  
North East ◽  
Total Cohort ◽  
Anti Cancer ◽  
One Year

AbstractObjectivesThe National Mesothelioma Audit 2020 showed Northumbria to have low rates of histopathological confirmation, treatment and one-year survival rates for malignant pleural mesothelioma (MPM). We hypothesized that an internal analysis over a 10-year period provides valuable insights into presentation, diagnosis, treatment and outcomes.MethodsA single-centre retrospective case series of all confirmed MPM patients between 1 January 2009 and 31 December 2019 was performed. Demographics, clinical, radiological and histopathological characteristics and outcomes were collected. Statistical analysis was performed using SPSS V26.0.ResultsA total of 247 patients had MPM. About 86% were male, mean age 75.7 years. Dyspnoea (77.4%) and chest pain (38.5%) were commonest symptoms. 64.9 and 71.4% had pleural thickening and effusion, respectively. About 86.8% had at least one attempt to obtain a tissue biopsy, but histopathological confirmation in only 108 (43.7%). About 66.3% with PS 0 and 1 (62.7% of total cohort) had at least one anti-cancer therapy. Death within 12 months was associated with disease progression within 6 months (p≤0.001). Chemotherapy (p≤0.001) and epithelioid histological subtype (p=0.01) were protective.ConclusionsThis study confirms known epidemiology of MPM, demonstrates variability in practices and highlights how some NMA recommendations are not met. This provides the incentive for a regional mesothelioma multi-disciplinary meeting.

scholarly journals Granulomatosis with Polyangiitis Presenting with Bilateral Orbital Apex Syndrome

2021 ◽  
pp. 32-40
Author(s):  
Yusuke Murai ◽  
Takuji Kurimoto ◽  
Sotaro Mori ◽  
Kaori Ueda ◽  
Mari Sakamoto ◽  
...  
Keyword(s):  
Visual Field ◽  
Eye Movement ◽  
Endoscopic Sinus Surgery ◽  
Granulomatosis With Polyangiitis ◽  
Field Tests ◽  
Sinus Surgery ◽  
Orbital Apex ◽  
Orbital Apex Syndrome ◽  
Initial Examination ◽  
Steroid Pulse

We report a rare case of granulomatosis with polyangiitis (GPA) presenting with bilateral orbital apex syndrome (OAS). A 73-year-old woman with a history of endoscopic sinus surgery for ethmoidal sinusitis experienced a sudden decrease in visual acuity (VA) of both eyes. At the initial examination, her VA had decreased to 0.01 in the right eye and 0.03 in the left eye, and eye movement in both eyes was mildly limited in all directions. Visual field tests of both eyes showed a large central scotoma. Laboratory tests revealed an elevation of myeloperoxidase-anti-neutrophil cytoplasmic antibody. Facial computed tomography demonstrated a thickened mucosal membrane in the entire ethmoidal sinus, and the posterosuperior walls of Onodi cells filled with infiltrative lesions had thinned. Orbital magnetic resonance imaging showed severe inflammation in the orbital apex. From these clinical findings, the patient was diagnosed with GPA presenting with OAS associated with ethmoid sinusitis. Emergent endoscopic sinus surgery was performed for biopsy and debridement of the ethmoidal and sphenoid sinusitis to decompress the optic nerve. One day after endoscopic sinus surgery, the patient’s VA and visual field were improved, and steroid pulse therapy was commenced postoperatively. Four days later, VA had recovered to 1.0 in both eyes, and eye movement and visual field had were improved. Although OAS is a rare manifestation, early surgical treatment should be considered when the orbital lesion presents as risk of rapid deterioration of visual function in patients with GPA.

scholarly journals 1-Year Evaluation of OT Bridge Abutments for Immediately Loaded Maxillary Fixed Restorations: A Multicenter Study

2021 ◽  
Author(s):  
Rosario Acampora ◽  
Marco Montanari ◽  
Roberto Scrascia ◽  
Emiliano Ferrari ◽  
Massimo Pasi ◽  
...  
Keyword(s):  
Survival Rates ◽  
Health Impact ◽  
P Value ◽  
Success Rates ◽  
Marginal Bone Loss ◽  
Bridge Abutments ◽  
Bleeding On Probing ◽  
Fixed Dental Prosthesis ◽  
Low Profile ◽  
One Year

Abstract Objective  Preliminary data on survival and success rates of immediately loaded, maxillary, screw-retained, implant-supported, fixed restorations delivered on narrow and low-profile OT Equator abutments (OT Bridge, Rhein’83) were evaluated. Materials and Methods This retrospective study evaluated data collected from patients rehabilitated with OT Bridge prosthetic concept between November 2017 and February 2019 in six different centers. Outcome measures were implant and prosthetic survival rates, biological and technical complications, marginal bone loss (MBL), oral health impact profile (OHIP), bleeding on probing, and plaque index. Results A total of 76 implants were inserted in 14 patients. Patients were followed for a mean period of 15.8 months (range = 12–24). All the patients receive OT Equator (Rhein'83) as intermediate abutments. One year after loading, one implant failed (1.3%). None of the prosthesis failed. One prosthetic complication was experienced in one patient. Three out of 76 implants were connected to the prosthetic framework using only the Seeger system, without screw. Difference in OHIP values was statistically significant (71.9 ± 8.5; p = 0.000). One year after loading, MBL was 0.21 ± 0.11 mm and p-value was 0.000. One year after loading, 8.7% of the examined implant sites present positive bleeding on probing, while 6.4% of the implant sites presented plaque. Conclusion The OT Equator abutments (Rhein'83) showed successful results when used to support maxillary fixed dental prosthesis delivered on four to six implants. High implant and prosthetic survival rates, very low complications, high patient satisfaction, and good biological parameters, including only 0.2 mm of bone remodeling were experienced one year after function. Further studies are needed to confirm these preliminary results.

scholarly journals Early Administration of Tolvaptan Can Improve Survival in Patients with Cirrhotic Ascites

2021 ◽  
Vol 10 (2) ◽  
pp. 294
Author(s):  
Atsushi Hosui ◽  
Takafumi Tanimoto ◽  
Toru Okahara ◽  
Munehiro Ashida ◽  
Kohsaku Ohnishi ◽  
...  
Keyword(s):  
Conventional Therapy ◽  
Low Dose ◽  
Therapy Group ◽  
Survival Rates ◽  
Refractory Ascites ◽  
High Dose ◽  
Term Survival ◽  
Conventional Therapy Group ◽  
One Year ◽  
The One

(1) Backgrounds and aim: Tolvaptan, a selective vasopressin type 2 receptor antagonist, was approved for ascites, and its short-term efficacy and safety have been confirmed. However, it is still unclear whether this novel drug may improve long-term survival rates in cirrhotic patients with ascites. (2) Patients and methods: A total of 206 patients who responded insufficiently to conventional diuretics and were hospitalized for refractory ascites for the first time were retrospectively enrolled in this study. Among them, the first 57 consecutive patients were treated with conventional diuretics (the conventional therapy group); the latter 149 consecutive patients were treated with tolvaptan in addition to the conventional therapy (the tolvaptan group). (3) Results: The exacerbation of renal function was significantly milder in the tolvaptan group than in the conventional therapy group. The prognostic factors for survival in the tolvaptan group were being male, having hyperbilirubinemia, having a high blood urea nitrogen (BUN), and receiving high-dose furosemide at the start of tolvaptan treatment. The one-year and three-year cumulative survival rates were 67.8 and 45.3%, respectively, in patients with low-dose furosemide (<40 mg/day) at the start of tolvaptan treatment. The prognosis was significantly better in the tolvaptan group with low-dose furosemide than in the conventional therapy group (p < 0.001). (4) Conclusion: Tolvaptan can improve survival in patients with cirrhotic ascites, especially when tolvaptan is started before high-dose furosemide administration.

scholarly journals A Dutch phase III randomized multicenter trial: whole brain radiotherapy vs. stereotactic radiotherapy for 4-10 brain metastases

2021 ◽  
Author(s):  
Dianne Hartgerink ◽  
Anna Bruynzeel ◽  
Danielle Eekers ◽  
Ans Swinnen ◽  
Coen Hurkmans ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Side Effects ◽  
Brain Metastases ◽  
Survival Rates ◽  
Whole Brain Radiotherapy ◽  
Phase Iii ◽  
Whole Brain ◽  
Brain Radiotherapy ◽  
One Year

Abstract Background The clinical value of whole brain radiotherapy (WBRT) for brain metastases (BM) is a matter of debate due to the significant side effects involved. Stereotactic radiosurgery (SRS) is an attractive alternative treatment option that may avoid these side effects and improve local tumor control. We initiated a randomized trial (NCT02353000) to investigate whether quality of life is better preserved after SRS compared with WBRT in patients with multiple brain metastases. Methods Patients with 4 to 10 BM were randomized between the standard arm WBRT (total dose 20 Gy in 5 fractions) or SRS (single fraction or 3 fractions). The primary endpoint was the difference in quality of life (QOL) at three months post-treatment. Results The study was prematurely closed due to poor accrual. A total of 29 patients (13%) were randomized, of which 15 patients have been treated with SRS and 14 patients with WBRT. The median number of lesions were 6 (range, 4-9) and the median total treatment volume was 13.0 cc 3 (range, 1.8-25.9 cc 3). QOL at three months decreased in the SRS group by 0.1 (SD=0.2), compared to 0.2 (SD=0.2) in the WBRT group (p=0.23). The actuarial one-year survival rates were 57% (SRS) and 31% (WBRT) (p=0.52). The actuarial one-year brain salvage-free survival rates were 50% (SRS) and 78% (WBRT) (p=0.22). Conclusion In patients with 4 to 10 BM, SRS alone resulted in one-year survival for 57% of patients while maintaining quality of life. Due to the premature closure of the trial, no statistically significant differences could be determined.

scholarly journals Orbital apex syndrome without MRI lesion caused by ANCA-associated vasculitis

2014 ◽  
Vol 54 (2) ◽  
pp. 158-161
Author(s):  
Hiroaki Iwanami ◽  
Hirotaka Katoh ◽  
Youhei Ohnaka ◽  
Masashi Nakajima ◽  
Mitsuru Kawamura
Keyword(s):  
Orbital Apex ◽  
Orbital Apex Syndrome ◽  
Anca Associated Vasculitis
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