Publications by authors named "Alejandra Valenzuela"

43 Publications

Richter´s Hernia Incarcerated Bowel Hernia at 5mm Port Site.

J Minim Invasive Gynecol 2021 Nov 21. Epub 2021 Nov 21.

Department of Obstetrics and Gynecology, Division of Gynecology Oncology, Universidad Autónoma de Chihuahua, Hospital Christus Muguerza Del Parque, Chihuahua México (all authors).

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http://dx.doi.org/10.1016/j.jmig.2021.11.014DOI Listing
November 2021

Autism Detection in Children by Combined Use of Gaze Preference and the M-CHAT-R in a Resource-Scarce Setting.

J Autism Dev Disord 2021 Mar 16;51(3):994-1006. Epub 2021 Feb 16.

Bioinformatics and Molecular Biology Laboratory, Research and Development Laboratory, Science and Philosophy Faculty, Universidad Peruana Cayetano Heredia, Lima, Peru.

Most children with autism spectrum disorder (ASD), in resource-limited settings (RLS), are diagnosed after the age of four. Our work confirmed and extended results of Pierce that eye tracking could discriminate between typically developing (TD) children and those with ASD. We demonstrated the initial 15 s was at least as discriminating as the entire video. We evaluated the GP-MCHAT-R, which combines the first 15 s of manually-coded gaze preference (GP) video with M-CHAT-R results on 73 TD children and 28 children with ASD, 36-99 months of age. The GP-MCHAT-R (AUC = 0.89 (95%CI: 0.82-0.95)), performed significantly better than the MCHAT-R (AUC = 0.78 (95%CI: 0.71-0.85)) and gaze preference (AUC = 0.76 (95%CI: 0.64-0.88)) alone. This tool may enable early screening for ASD in RLS.
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http://dx.doi.org/10.1007/s10803-021-04878-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7954728PMC
March 2021

Early orbital infantile hemangioma that emphasizes the importance of glucose-transporter-1 (GLUT-1).

Can J Ophthalmol 2018 04 22;53(2):e58-e60. Epub 2017 Sep 22.

Tulane University Department of Ophthalmology, New Orleans, LA. Electronic address:

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http://dx.doi.org/10.1016/j.jcjo.2017.07.003DOI Listing
April 2018

Multicentred international review of orbital exenteration and reconstruction in oculoplastic and orbit practice.

Br J Ophthalmol 2018 05 26;102(5):654-658. Epub 2017 Aug 26.

Department of Ophthalmology, Tulane University School of Medicine, New Orleans, Louisiana, USA.

Background: Orbital exenteration is a disfiguring procedure reserved for life-threatening malignancies. This study examines the clinical course and outcomes of a large series of patients who underwent orbital exenteration for malignant periocular neoplasms.

Methods: This is a retrospective review of patients who underwent orbital exenteration from 1 July 2005 to 30 June 2015 at four tertiary referral centres in the USA, Australia and Canada. Demographics, indication for surgery, pathology, surgical technique, reconstruction type and outcomes were reviewed.

Results: Orbital exenteration was performed on 102 patients. The mean age at surgery was 67.5 years. The most common malignant tumours encountered were squamous cell carcinoma, melanoma and basal cell carcinoma. Seventy-six patients (75%) underwent reconstruction with a local myocutaneous flap, twelve with partial-thickness skin grafts (PTSG), or split skin graft, two had a free flap, and one had a dermis fat graft. Sixteen patients had combined procedures of two of the above. Complete removal of the tumour was achieved with clear margins in 81 cases. Of all patients, 72% were alive at 48 months or more.

Conclusion: The majority of orbital exenterations performed in this series were secondary to periocular malignancies with unsuccessful/insufficient previous treatments. Regional myocutaneous flaps, PTSG, full-thickness skin grafts and dermis fat grafts were all highly effective and durable reconstructive options, and were able to withstand radiation therapy without complications.
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http://dx.doi.org/10.1136/bjophthalmol-2017-310681DOI Listing
May 2018

BB pellet extraction from the anterior orbit using manual expression.

Can J Ophthalmol 2017 Aug 8;52(4):e128-e130. Epub 2017 Feb 8.

Tulane University Department of Ophthalmology, New Orleans, La. Electronic address:

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http://dx.doi.org/10.1016/j.jcjo.2016.12.006DOI Listing
August 2017

Glasses: Hiding or causing skin cancer?

Orbit 2016 Oct 10;35(5):262-6. Epub 2016 Aug 10.

a Department of Ophthalmology , Tulane University, Tulane Health Sciences Center , New Orleans , Louisiana , USA.

This article evaluates malignant transformation of lesions presenting in the periocular skin under the eye spectacle nose pad. A non-comparative retrospective chart review of clinical features and pathological findings of patients presenting with periocular malignancies in the exact vicinity where the nose pads of their eye spectacles rested was completed. The study took place in one tertiary oculoplastic referral center between 2007-2013. Ten patients were included, six of whom were male. All subjects wore eye spectacles while awake for at least 15 years, and had an evident suspicious lesion in the exact area that coincided with the resting place of the nose pad. The mean age was 73.5 years (range 65-85 years) and all patients had the lesion present for at least one year. Most cases were squamous skin malignancies (five squamous cell carcinomas [SCC], 2 intra-epidermal carcinomas [IEC], while 3 basal cell carcinomas [BCC]). Treatment involved surgical excision of the lesion with frozen section for margin control and reconstruction with a myocutaneous flap. Periocular malignancies of the inferior medial canthal area, where the nose pad of eye spectacle places pressure, can be easily missed or misdiagnosed. Marjolin ulcers (MU) classically present as an aggressive SCC in area of chronic inflammation, which has been previously correlated to constant pressure, repetitive trauma, or non-healing wounds in other areas of the body. We propose that the traumatic chronic pressure in the infero-medial canthal region from long-term eye spectacle nose pad use, may induce poor lymphatic regeneration leading to an immune system deficiency that predisposes this skin to a malignant transformation. The presence of chronic eye spectacle nose pads also prevents proper and timely detection of such malignancies. Complete excision of these lesions with margin control, adequate follow-up for possible recurrence, and surveillance for new lesions on the patient's contralateral side, is crucial for adequate management.
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http://dx.doi.org/10.1080/01676830.2016.1193525DOI Listing
October 2016

The malignancy masquerader: hyperostosis and bone marrow hypertrophy after pleomorphic adenoma removal.

Can J Ophthalmol 2015 Dec;50(6):e104-6

Tulane University School of Medicine, New Orleans, La.

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http://dx.doi.org/10.1016/j.jcjo.2015.08.004DOI Listing
December 2015

A Cyst You Can't Miss: A Rare Presentation of an Orbital Apocrine Hidrocystoma.

Orbit 2015 8;34(4):229-31. Epub 2015 May 8.

Department of Ophthalmology, Tulane University School of Medicine , New Orleans, Louisiana , USA and.

Apocrine hidrocystomas are benign cystic lesions derived from the sweat glands of Moll and seldom found in the orbit. The authors present a case of a 41-year-old healthy man, with no prior medical history, referred for a painless enlarging mass, medial to his right upper eyelid for the past 3 months. Computed tomography showed a well-defined cystic lesion localized in the supero-medial anterior orbit. Following complete excision of the lesion, histopathology revealed an apocrine hidrocystoma. Although rare, apocrine hidrocystomas should be considered in the differential diagnosis for cystic mass of the orbit at any age group.
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http://dx.doi.org/10.3109/01676830.2015.1014514DOI Listing
May 2016

Diagnostic challenges in primary orbital fibrosarcoma: a case report.

Clin Ophthalmol 2014 20;8:2319-23. Epub 2014 Nov 20.

Department of Ophthalmology, School of Medicine, Tulane University, New Orleans, LA, USA.

Fibrosarcoma is a rare and malignant spindle cell tumor of mesenchymal origin that infrequently presents in the orbit. Evolving diagnostic criteria confound the identification of these tumors, as well as the interpretation of previous studies on this unusual entity. We report a case of a 66-year-old man with a mass on his left inferior orbit, with associated paresthesia. A computed tomography (CT) scan showed a lesion on the left anteroinferomedial orbit, with bone erosion. An en bloc surgical excision followed by a thorough immunohistologic evaluation allowed diagnosis of an orbital fibrosarcoma. The patient has had no recurrence after 14 months of follow up. Once a commonly identified soft tissue malignancy, fibrosarcoma has become a diagnosis of exclusion as a result of improved diagnostic and classification techniques, such as immunohistochemistry and fluorescence in situ hybridization (FISH). This type of soft tissue tumor is now an uncommon entity, and we report the first case of a primary orbital fibrosarcoma in an adult, using modern diagnostic and classification methods.
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http://dx.doi.org/10.2147/OPTH.S70843DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4242685PMC
November 2014

Sphenoid sinus dehiscence as a risk for visual consequences in an immunocompromised patient.

J La State Med Soc 2014 Mar-Apr;166(2):70-2. Epub 2014 Apr 10.

Department of Radiology at Tulane University School of Medicine.

Isolated sphenoid sinus disease is a rare entity with severe and potentially life threatening sequela. Because of the proximity of the sinus to the orbit, anatomical defects within the surrounding bony structures can facilitate communication with orbital content, predisposing the patient to substantial visual consequences. We report a case of a 51-year-old immunocompromised male who presented with headache and gradual unilateral decreases in vision. Computed tomography revealed opacification of the left sphenoid sinus accompanied by unusual bony dehiscence of the proximal optic canal. Early recognition and treatment of sphenoid sinusitis requires urgent surgical intervention with delay of treatment potentially leading to irreversible blindness or other devastating consequences. Bony dehiscence of the sphenoid sinus overlying the optic nerve has only been found in 4% of cadavers. It is associated with increased risk of orbital complications and predicts a poor prognosis. Immediate intervention is particularly important in immunocompromised individuals who are at greater risk of these severe complications.
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January 2017

Orbital solitary fibrous tumor: a case series with review of the literature.

Orbit 2014 Apr 2;33(2):145-51. Epub 2013 Dec 2.

Department of Ophthalmology, Tulane University School of Medicine , New Orleans, Louisiana , USA.

Purpose: To report the clinical features, patient demographics, management, and outcomes of a series of patients with orbital solitary fibrous tumors (OSFTs) and provide a review of the English literature describing this rare entity.

Design: A review of patient demographics, clinical presentations, imaging, histopathology, surgical management, and outcomes were analyzed.

Methods: A non-comparative retrospective chart review of the demographics, clinical presentations, imaging, histopathological features, management, and disease outcomes of patients presenting to a tertiary orbital center with a tissue diagnosis of OSFT between 2007-2012 was performed along with a review of the English-language literature.

Results: Our study included four male patients, with a mean age of 48 years at referral. The most common presentations included a slowly growing mass, globe displacement, diplopia on extreme gazes, and/or facial disfiguration. All tumors were analyzed with histopathology and immunohistochemistry. Treatment involved the complete surgical excision of the lesion, obtaining clear margins. All patients remain alive and well with no evidence of recurrence after a minimum follow-up of 15 months (range 15 months-5 years).

Conclusion: SFTs should be considered when confronting a painless slowly growing orbital mass that induces globe displacement and/or facial deformity. Imaging will show a well-defined lesion that enhances with contrast. A careful initial surgical excision with clear margins is required for adequate local control of the tumor, avoiding recurrence and potential malignant transformation.
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http://dx.doi.org/10.3109/01676830.2013.853806DOI Listing
April 2014

Septic cavernous sinus thrombosis with diffuse spread leading to cerebral ischemia.

Orbit 2013 Oct 2;32(5):330-2. Epub 2013 Aug 2.

Department of Ophthalmology, Tulane Medical School, New Orleans , Louisiana , USA.

Introduction: Septic cavernous sinus thrombosis (CST) is a rare disease with many etiologies and a diffuse array of initial presentation leading to high mortality.

Case: A 25-year-old male with a history of a nasal furuncle presents with an acute onset of fixed and dilated pupils, bilateral exophthalmos, hemorrhagic chemosis, elevated intraocular pressures, restricted extraocular motility, and unresponsiveness. A retinal septic emboli in the left eye is present on dilated fundoscopic exam while an exudative retinal detachment is present in the right eye. MRI/MRV revealed extensive thrombosis of cavernous sinuses, distal sigmoid dural sinuses, and proximal internal jugular veins with associated cerebral edema and multifocal areas of venous infarction. Blood cultures grew Methicillin-resistant Staphylococcus aureus and the patient suffered multi-system organ failure. Despite treatment with full dose systemic anticoagulation and broad spectrum antibiotics the patient suffered a cardiopulmonary arrest and expired.

Comment: The acuity of onset coupled with the multiple risk factors for septic cavernous sinus thrombosis in this patient led to a fulminant presentation of this disease and ultimate poor outcome.
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http://dx.doi.org/10.3109/01676830.2013.814686DOI Listing
October 2013

Combined surgical and sclerotherapy for an extensive venous-lymphatic orbital anomaly.

J AAPOS 2013 Aug 16;17(4):434-6. Epub 2013 Jul 16.

Department of Ophthalmology, Tulane Health Science Centre, Tulane University, New Orleans, Louisiana, USA.

Combined venous-lymphatic anomalies (lymphangiomas) of the orbit are nonhereditary, congenital lesions. We report the case of a 6-year-old boy with an extensive right orbital venous-lymphatic anomaly and severe facial deformity who developed 3 intraconal hemorrhages over 3 months. Although the visual acuity was recovered in the first two surgical interventions, the last episode of bleeding resulted in permanent visual acuity loss. At that stage, adjunctive therapy with n-butyl-cyanoacrylate allowed for greater surgical excision. No further episodes of recurrent hemorrhage occurred and the exophthalmos was corrected, thereby improving his overall cosmesis.
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http://dx.doi.org/10.1016/j.jaapos.2013.03.015DOI Listing
August 2013

Comparison of 26 sphingomonad genomes reveals diverse environmental adaptations and biodegradative capabilities.

Appl Environ Microbiol 2013 Jun 5;79(12):3724-33. Epub 2013 Apr 5.

DOE Great Lakes Bioenergy Research Center, University of Wisconsin-Madison, Madison, WI, USA.

Sphingomonads comprise a physiologically versatile group within the Alphaproteobacteria that includes strains of interest for biotechnology, human health, and environmental nutrient cycling. In this study, we compared 26 sphingomonad genome sequences to gain insight into their ecology, metabolic versatility, and environmental adaptations. Our multilocus phylogenetic and average amino acid identity (AAI) analyses confirm that Sphingomonas, Sphingobium, Sphingopyxis, and Novosphingobium are well-resolved monophyletic groups with the exception of Sphingomonas sp. strain SKA58, which we propose belongs to the genus Sphingobium. Our pan-genomic analysis of sphingomonads reveals numerous species-specific open reading frames (ORFs) but few signatures of genus-specific cores. The organization and coding potential of the sphingomonad genomes appear to be highly variable, and plasmid-mediated gene transfer and chromosome-plasmid recombination, together with prophage- and transposon-mediated rearrangements, appear to play prominent roles in the genome evolution of this group. We find that many of the sphingomonad genomes encode numerous oxygenases and glycoside hydrolases, which are likely responsible for their ability to degrade various recalcitrant aromatic compounds and polysaccharides, respectively. Many of these enzymes are encoded on megaplasmids, suggesting that they may be readily transferred between species. We also identified enzymes putatively used for the catabolism of sulfonate and nitroaromatic compounds in many of the genomes, suggesting that plant-based compounds or chemical contaminants may be sources of nitrogen and sulfur. Many of these sphingomonads appear to be adapted to oligotrophic environments, but several contain genomic features indicative of host associations. Our work provides a basis for understanding the ecological strategies employed by sphingomonads and their role in environmental nutrient cycling.
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http://dx.doi.org/10.1128/AEM.00518-13DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3675938PMC
June 2013

Traumatic superior ophthalmic vein thrombosis in a child.

Orbit 2012 Oct 1;31(5):355-7. Epub 2012 Aug 1.

Department of Ophthalmology, Tulane Health Science Centre, Tulane University, New Orleans, LA, USA.

Superior ophthalmic vein thrombosis (SOVT) is a rare condition of multiple etiologies that generally presents with proptosis, ophthalmoplegia, periorbital edema, and occasionally decreased visual acuity. We describe a unique case of a two-year-old child presenting with extensive superior forniceal chemosis obstructing the visual axis after trauma in a motor vehicle accident. Angiography revealed complete thrombosis of the superior ophthalmic vein. Management and outcome are also discussed.
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http://dx.doi.org/10.3109/01676830.2012.700546DOI Listing
October 2012

Eye Popping Disease: Common Characteristics and Management of Spontaneous Globe Subluxation.

Asia Pac J Ophthalmol (Phila) 2012 Jul-Aug;1(4):198-201

From the *Department of Ophthalmology, Tulane Health Science Center, Tulane University, New Orleans, LA; and †Department of Ophthalmology, Dalhousie University, Halifax, Nova Scotia, Canada.

Purpose: The objective of this study was to describe the clinical features, predisposing factors, and management of 8 new cases of spontaneous globe subluxation (SGS) and provide a review of the relevant literature.

Design: Patient demographics, clinical presentations, investigations, management, complications, and outcomes were measured.

Methods: This was a retrospective, case-note analysis of 8 patients with SGS and a major review of the English-language literature.

Results: Eight new cases of spontaneous globe subluxation were identified with varying clinical manifestations and treatments. Literature review has shown less than 50 cases. Space-occupying lesions such as thyroid eye disease, shallow orbits, and floppy eyelids were major contributors to predisposition to SGS.

Conclusions: Orbital congestion, shallow orbits, and floppy eyelids can all play a role in predisposing patients to SGS. Successful surgical management of SGS, when required, should be tailored to the individual patient profile for best results.
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http://dx.doi.org/10.1097/APO.0b013e31825ee12fDOI Listing
June 2015

Acute orbital inflammatory syndrome secondary to an ANCA-positive small-vessel vasculitis: a case report and review of the literature.

Orbit 2012 Oct 29;31(5):321-3. Epub 2012 May 29.

Department of Ophthalmology, Dalhousie University , Halifax , Canada.

A 61-year-old man presents with sequential painful bilateral proptosis within 36 h and orbital compartment syndrome resulting in complete loss of vision bilaterally. Sequential urgent lateral canthotomy and cantholysis were performed to reverse the compartment syndrome. Orbital imaging showed non-specific orbital inflammation. Biopsies showed necrotizing inflammation and bloodwork was positive for c-ANCA. The patient was therefore treated with prednisone and cyclophosphomide and showed good recovery of vision in one eye, and had no recurrence of orbital inflammation. ANCA-associated orbital vasculitides are rare, but must be kept in mind in the differential diagnosis of acute orbital inflammatory syndromes.
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http://dx.doi.org/10.3109/01676830.2012.678547DOI Listing
October 2012

Primary apocrine adenocarcinoma of the eyelid.

Orbit 2012 Oct 9;31(5):316-8. Epub 2012 May 9.

Department of Ophthalmology, Tulane University, New Orleans, LA, USA.

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http://dx.doi.org/10.3109/01676830.2011.647378DOI Listing
October 2012

Apocrine hidrocystoma of the orbit.

Orbit 2011 Dec;30(6):316-7

Department of Ophthalmology, Tulane Health Science Centre, Tulane University, New Orleans, Louisiana 70112, USA.

Apocrine hidrocystomas are benign cysts of sweat duct origin, originating mainly from the apocrine secretory glands of Moll. They are typically encountered in the head and neck, particularly around the inner canthus of the eyelid. An intraorbital location of this lesion is extremely rare but should be considered in the differential diagnosis of a painless cystic lesion in the ocular adnexa at any age.
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http://dx.doi.org/10.3109/01676830.2011.621170DOI Listing
December 2011

Lacrimal caruncle: continuation to the lower eyelid retractors.

Ophthalmic Plast Reconstr Surg 2011 May-Jun;27(3):198-200

Department of Ophthalmology, Aichi Medical University, Nagakute, Aichi, Japan.

Purpose: To examine the relationship between the lacrimal caruncle and the lower eyelid retractors and to study the shape and position of the lacrimal caruncle in relation to the lower eyelid margin.

Methods: A transcaruncular approach was used to investigate the direction of the lacrimal caruncle shift in 14 medial orbital decompressions (7 patients) and 10 medial orbital wall fracture reductions (10 patients). Eighty lacrimal caruncles in 40 normal volunteers were examined regarding the position of this structure in relation to the lower eyelid retractors and its shape in connection to the lower eyelid margin. Direct investigation of whether the lower eyelid retractors continued to the lacrimal caruncle was performed during 4 lazy-T procedures (2 patients).

Results: All the severed lacrimal caruncles moved inferolaterally. The volunteers' lacrimal caruncles were situated adjacent to the lower eyelid retractors, had an ovoid shape, and were positioned obliquely with an inferolateral direction. In the normal eyelid position, the superior border of the lacrimal caruncle was aligned with the lower eyelid margin. During the lazy-T procedures, the lower eyelid retractors were shown to have direct connection to the lacrimal caruncle.

Conclusion: The lacrimal caruncle has a direct connection to the lower eyelid retractors that plays an antagonistic role to the medial rectus caspulopalpebral fascia in the movement of the lacrimal caruncle, and it is positioned obliquely, directing inferolaterally with its superior border in level with the lower eyelid margin.
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http://dx.doi.org/10.1097/IOP.0b013e3181ed3573DOI Listing
August 2011

Heavy metals in northern Chilean rivers: spatial variation and temporal trends.

J Hazard Mater 2010 Sep 24;181(1-3):747-54. Epub 2010 May 24.

Departamento de Ingeniería Geográfica, Facultad de Ingeniería, Universidad de Santiago de Chile, Santiago, Chile.

Rivers of central-northern Chile are exposed to pollution from different sources, including mining activities, natural orogenic process, volcanic activity, and geology. In order to determine the contribution of mining to river pollution, the spatio-temporal dynamics of chemical species dissolved in 12 rivers of central-northern Chile was assessed. Of all the rivers studied, the Elqui showed the highest historical mean concentrations of As, Cu and Pb. The Aconcagua had the highest concentration of Hg and a large Cr concentration, while the Rapel showed elevated concentrations of Cu and Mo. The Elqui and the Aconcagua were clustered as distinct groups by a cluster analysis based on two independent principal components. Hierarchical Bayesian models showed annual trends but no seasonal effects in heavy metal concentrations. As and Cu in the Elqui had positive annual slopes. Sulphate concentration exceeded 100 mg L(-1) in nine rivers, and in seven of them it had positive annual slopes. Our findings suggest that mining pollution is the main process contributing to this increasing annual trend in As, Cu and SO(4)(2-). Therefore, in order to improve the water quality of these rivers it is necessary to identify the main sources of heavy metals associated with mining activities.
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http://dx.doi.org/10.1016/j.jhazmat.2010.05.076DOI Listing
September 2010

Orbital metastasis: clinical features, management and outcome.

Orbit 2009 ;28(2-3):153-9

Orbital, Lacrimal and Oculoplastic Clinic, Department of Ophthalmology & Visual Sciences, QEII Health Sciences Centre, Dalhousie University, Halifax, Canada.

Purpose: To review the clinical features, treatment, outcome and survival of metastatic tumors of the orbit.

Materials And Methods: Retrospective, non-comparative, chart review of 80 patients with orbital metastasis treated in four tertiary orbital centres in Australia.

Results: The study included 80 patients of which, 44 were male with a mean age of 60 years. Orbital involvement commonly presented late in a multisystemic disease; however, the orbit was the first presentation in 15% of the cases. Diplopia (48%), pain (42%), and visual loss (30%) were the commonest symptoms at presentation; whereas proptosis (63%), strabismus (62%), and visual loss (41%) were the most frequent clinical signs. Computed tomography commonly showed a solid enhancing mass (42 cases) located within the orbital fat (43%), or enlarging an extraocular muscle (28%). Breast carcinoma (29%), melanoma (20%), and prostatic cancer (13%) were the most frequent histological types. Treatment was often multi-disciplinary and modalities included radiotherapy, chemotherapy, hormone therapy, surgery, and immunotherapy. Survival was limited to 1.5 years after diagnosis independent of the histological type, with 29% of patients alive after 17 months follow-up.

Conclusions: A high index of suspicion and appropriate intervention with histological diagnosis can help in the management and quality of life in patients with metastatic orbital disease. Overall survival is limited and we encountered statistical limitations proving differences in the survival based on the sub-type of primary tumour involved. Metastatic orbital melanoma presented a higher incidence when compared with previous studies, probably due to the increase frequency of skin found in the Australian population.
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http://dx.doi.org/10.1080/01676830902897470DOI Listing
January 2010

Pedobacter nyackensis sp. nov., Pedobacter alluvionis sp. nov. and Pedobacter borealis sp. nov., isolated from Montana flood-plain sediment and forest soil.

Int J Syst Evol Microbiol 2009 Jul 19;59(Pt 7):1720-6. Epub 2009 Jun 19.

Microbial Ecology Program, Division of Biological Sciences, The University of Montana, Missoula, MT 59812-1006, USA.

Three Gram-negative, rod-shaped, non-spore-forming eubacterial strains were isolated in western Montana, USA, and subjected to taxonomic studies. Strains NWG-II14(T) and NWER-II11(T) were isolated from hyporheic sediments of a large alluvial flood plain, whereas strain G-1(T) was isolated from a conifer forest soil. On the basis of 16S rRNA gene sequence similarity, strains NWG-II14(T), NWER-II11(T) and G-1(T) were shown to belong to the family Sphingobacteriaceae and are most closely related to various species of the genus Pedobacter. The results of molecular, physiological and biochemical tests allowed genotypic and phenotypic differentiation of these three strains from 23 Pedobacter species with validly published names. The three isolates therefore represent novel species, for which the names Pedobacter nyackensis sp. nov. (type strain NWG-II14(T) =DSM 19625(T) =LMG 24260(T)), Pedobacter alluvionis sp. nov. (type strain NWER-II11(T) =DSM 19624(T) =LMG 24258(T)) and Pedobacter borealis sp. nov. (type strain G-1(T) =DSM 19626(T) =LMG 24259(T)) are proposed.
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http://dx.doi.org/10.1099/ijs.0.000158-0DOI Listing
July 2009

Orbital arteriovenous malformations.

Arch Ophthalmol 2008 Dec;126(12):1669-75

South Australian Institute of Ophthalmology and Discipline of Ophthalmology and Visual Sciences, University of Adelaide, Adelaide, SA, Australia.

Objective: To present the clinical features, management, and outcomes in a series of patients with orbital arteriovenous malformations (AVMs).

Methods: Clinical records of patients with orbital AVMs confirmed using angiography were reviewed as a retrospective, noncomparative, interventional case series.

Results: Eight patients (3 women and 5 men) with unilateral AVMs and a mean age of 39 years (median, 36.5 years; range, 26-70 years) were reviewed. Findings existed for an average of 11.2 years before diagnosis and included periocular mass (7 patients, 88%); periocular edema, pulsation/bruit, proptosis, episcleral congestion, and previous trauma (4 patients each, 50%); elevated intraocular pressure (3 patients, 38%); pain and reduced visual acuity (2 patients each, 25%); and restriction of extraocular movements, and diplopia (1 patient each, 12%). All of the patients except 1 underwent surgical resection, with 3 (38%) receiving preoperative embolization of feeder vessels; all of the patients had initial resolution of manifestations after treatment.

Conclusions: Angiography is essential for diagnosis and for planning the management of orbital AVMs. Treatment depends on patient-specific features and includes observation, embolization, and surgical excision or combined preoperative embolization/excision. Given their vascular nature, the main cause of poor management outcomes is perioperative hemorrhage. Outcomes after a multidisciplinary approach are good, with few recurrences reported at follow-up.
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http://dx.doi.org/10.1001/archophthalmol.2008.501DOI Listing
December 2008

Plasmablastic lymphoma in the orbit: case report.

Orbit 2008 ;27(3):227-9

Department of Ophthalmology, Eyelid, Lacrimal, and Orbital Clinic, Royal Brisbane and Women's Hospital and the University of Queensland Medical School, Brisbane, Australia.

Plasmablastic lymphoma (PBL) is a rare entity most commonly identified in the oral cavity of immunodeficient patients. The immunophenotype of this condition shows a poor expression for B-cell markers but, in contrast, a strong reactivity for well-differentiated plasma cells markers, such as CD138, CD38, and epithelial membrane antigens. PBL survival is limited due to its highly aggressive local and metastatic behavior and poor response to treatment. Although it can involve different organs, there have been only a few cases involving the ocular adnexa. We describe a case of atypical rapidly progressive pre-septal brawny induration affecting the right orbit in a patient with HIV-related lymphoma.
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http://dx.doi.org/10.1080/01676830802014150DOI Listing
August 2008

Cerebrospinal fluid leaks in orbital and lacrimal surgery.

Surv Ophthalmol 2008 May-Jun;53(3):274-84

Oculoplastic and Orbital Division, Department of Ophthalmology & Visual Sciences, University of Adelaide, Adelaide, Australia.

Cerebrospinal fluid leakage is an uncommon but significant complication of orbital and rarely lacrimal surgery which may have serious consequences including death. In a retrospective review of four orbital units, we report an incidence of cerebrospinal fluid leak (diagnosed intraoperatively) during exenteration, orbital decompression, and dacryocystorhinostomy of 1/154 (0.6%), 4/397 (1%), and 0/3,504 (0%), respectively. We found two additional cases of cerebrospinal fluid leaks associated with excision of orbital masses involving the orbital roof. In the literature, the incidence of cerebrospinal fluid leaks associated with orbital exenterations and decompressions was 1.6-16.7% and 0-10%, respectively. Cerebrospinal fluid leaks occur very rarely in dacryocystorhinostomies with only a few case reports found in the literature. Preventative measures, diagnosis, and management of this complication are discussed. Knowledge of anatomy and thorough preoperative assessment may predict areas at high risk for encountering cerebrospinal fluid leaks. Proper surgical technique further minimizes the risk for this complication. If a cerebrospinal fluid leak occurs, however, prompt diagnosis and management usually results in uncomplicated recovery.
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http://dx.doi.org/10.1016/j.survophthal.2008.02.009DOI Listing
July 2008
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