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Baaklini C, Kesav N, Reinhart W. Minocycline-Induced Ocular Ochronosis. Cureus 2023; 15:e43307. [PMID: 37700983 PMCID: PMC10492665 DOI: 10.7759/cureus.43307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/09/2023] [Indexed: 09/14/2023] Open
Abstract
We report a case of minocycline-induced ocular ochronosis with scleral, retinal, and cutaneous manifestations. A 65-year-old male who had taken minocycline for four years to treat hidradenitis suppurativa, an inflammatory skin condition affecting the apocrine sweat glands and hair follicles, presented for evaluation of discoloration of bilateral sclera, nail beds, and gingiva. Ophthalmic evaluation revealed intact visual acuity, diffuse blue-gray hyperpigmentation of the sclera, more pronounced overlying insertions of the horizontal muscles, without any scleral thinning. Macular optical coherence tomography and fundus exam revealed a blue hue to the underlying choroid with dark deposits in the retinal pigment epithelium. Despite drug discontinuation, after six years the discoloration persisted. Management was directed towards patient tolerability.
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Affiliation(s)
| | - Natasha Kesav
- Ophthalmology, University Hospitals Cleveland Medical Center, Cleveland, USA
| | - William Reinhart
- Ophthalmology, University Hospitals Cleveland Medical Center, Cleveland, USA
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Pai K, Baaklini C, Cabrera CI, Tamaki A, Fowler N, Maronian N. The Utility of Comorbidity Indices in Assessing Head and Neck Surgery Outcomes: A Systematic Review. Laryngoscope 2021; 132:1388-1402. [PMID: 34661923 DOI: 10.1002/lary.29905] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 09/29/2021] [Accepted: 10/06/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To evaluate the utility of comorbidity index (CI) scores in predicting outcomes in head and neck surgery (HNS). The CIs evaluated were the Charlson Comorbidity Index (CCI), Elixhauser Comorbidity Index (ECI), Kaplan-Feinstein Index (KFI), American Society of Anesthesiologists Physical Status (ASA-PS), Adult Comorbidity Evaluation-27 (ACE-27), National Cancer Institute Comorbidity Index (NCI-CI), and the Washington University Head and Neck Comorbidity Index (WUHNCI). METHODS We report a systematic review according to the 2009 Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Electronic databases (PubMed, Cochrane, and Embase) and manual search of bibliographies identified manuscripts addressing how CI scores related to HNS outcomes. RESULTS A total of 116 studies associated CI scores with HNS outcomes. CIs were represented in the literature as follows: ASA-PS (70/116), CCI (39/116), ACE-27 (24/116), KFI (7/116), NCI-CI (3/116), ECI (2/116), and WUHNCI (1/116). The most frequently cited justification for calculating each CI (if provided) was: CCI for its validation in other studies, ACE-27 for its utility in cancer patients, and ECI for its comprehensive design. In general, the CCI and ACE-27 were predictive of mortality in HNS. The ECI was most consistent in predicting >1-year mortality. The ACE-27 and KFI were most consistent in predicting medical complications. CONCLUSION Despite inconsistencies in the literature, CIs provide insights into the impact of comorbidities on outcomes in HNS. These scores should be employed as an adjunct in the preoperative assessment of HNS patients. Comparative studies are needed to identify indices that are most reliable in predicting HNS outcomes. LEVEL OF EVIDENCE NA Laryngoscope, 2021.
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Affiliation(s)
- Kavya Pai
- University of Toledo College of Medicine and Life Sciences, Toledo, Ohio, U.S.A
| | - Carla Baaklini
- Northeast Ohio Medical University, Rootstown, Ohio, U.S.A
| | - Claudia I Cabrera
- Department of Otolaryngology-Head and Neck Surgery, University Hospitals Case Medical Center, Cleveland, Ohio, U.S.A.,Case Western Reserve University School of Medicine, Cleveland, Ohio, U.S.A
| | - Akina Tamaki
- Department of Otolaryngology-Head and Neck Surgery, University Hospitals Case Medical Center, Cleveland, Ohio, U.S.A.,Case Western Reserve University School of Medicine, Cleveland, Ohio, U.S.A
| | - Nicole Fowler
- Department of Otolaryngology-Head and Neck Surgery, University Hospitals Case Medical Center, Cleveland, Ohio, U.S.A.,Case Western Reserve University School of Medicine, Cleveland, Ohio, U.S.A
| | - Nicole Maronian
- Department of Otolaryngology-Head and Neck Surgery, University Hospitals Case Medical Center, Cleveland, Ohio, U.S.A.,Case Western Reserve University School of Medicine, Cleveland, Ohio, U.S.A
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Baaklini C, Menassa N, Larios JT, Ballas DA. A Simulation Model for External Cephalic Version. Cureus 2020; 12:e12382. [PMID: 33527060 PMCID: PMC7842254 DOI: 10.7759/cureus.12382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Breech presentation complicates as many as 4% of all deliveries. External cephalic version (ECV) is a procedure that involves the external rotation of the fetus through the mother’s abdomen from a breech position into a cephalic position. It provides a beneficial alternative to cesarean section (CS) as it is less invasive, more cost-effective, and mitigates many of the maternal health risks associated with CS. Though ECV has become more widely used in recent years, studies have shown that a large percentage of residency programs lack proper training pertaining to ECV, increasing the need for additional educational intervention. A well-supported method of procedural training that has demonstrated efficacy among trainees is the incorporation of simulation models. While many models have already been developed for various obstetrical procedures, few easily reproducible models currently exist for ECV. The purpose of this study was to develop a reconstructible ECV model that could be utilized for practice by trainees in the field of obstetrics. This study’s proposed ECV model along with a lecture that was presented to residents and data on the effectiveness of the model and comfort with performing the procedure was collected and analyzed. The results demonstrated that when compared to baseline prior to training, levels of comfort with performing an ECV increased amongst trainees after practicing on the model.
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Affiliation(s)
- Carla Baaklini
- Medicine, Northeast Ohio Medical University, Rootstown, USA
| | | | | | - Derek A Ballas
- Obstetrics and Gynecology, Summa Health System, Akron, USA
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Falcão J, Valim V, Titton D, Ranza R, Carvalho H, Bianchi W, Stadler B, Fernandes V, Louzada P, Bertolo M, Duarte A, Macieira J, Miranda J, Castelar G, Freire M, Toledo R, Moraes J, Costa I, Pereira I, Sauma M, Castro G, Brenol C, Zandonade E, Laurindo I, Baaklini C. FRI0195 Switching from anti-TNF To Non anti-TNF Therapy Yield Better Survival in Rheumatoid Arthritis (RA): Results from Brazilian Register of Biological Agents in Rheumatic Diseases – Biobadabrasil. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.4484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Ranza R, Laurindo I, Titton D, Bertolo M, Bianchi W, Brenol C, Carvalho H, Castro G, Cecconi M, Costa I, Duarte A, Fernandes V, Freire M, Louzada P, Maciera J, Miranda J, Moraes J, Pereira I, Pinheiro G, Sauma M, Stadler B, Toledo R, Valim V, Baaklini C, Descalzo M. SAT0601 Incidence of Serious Infections in Patients with Rheumatoid Arthritis and Spondyloarthritis Exposed To a-TNF Therapy. Results from Biobadabrasil Registry. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.5009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Carvalho H, Laurindo I, Ranza R, Titton D, Bertolo M, Bianchi W, Brenol C, Castelar G, Castro G, Costa I, Duarte A, Fernandes V, Freire M, Louzada P, Macieira J, MIranda J, Moraes J, Pereira I, Sauma M, Stadler B, Toledo R, Valim V, Baaklini C. SAT0586 Herpes Zoster in The Brazilian Register -Biobadabrasil. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.5238] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Ranza R, Laurindo I, Titton D, Bertolo M, Bianchi W, Brenol C, Bustamante M, Carvalho H, Castro G, Costa I, Duarte A, Fernandes V, Freire M, Louzada P, Maciera J, Miranda J, Moraes J, Pereira I, Pinheiro G, Sauma M, Stadler B, Toledo R, Valim V, Baaklini C, Descalzo M. THU0631 Incidence of Serious Adverse Events in Patients with Rheumatoid Arthritis Exposed To Biologic Therapies. Results from Biobadabrasil Registry. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.1560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Ranza R, Laurindo I, Titton D, Barbosa L, Bertolo M, Bertaccini J, Brenol C, Carvalho H, Castro G, Cecconi M, Costa I, Duarte A, Fernandes V, Freire M, Louzada P, Macieira J, Miranda J, Pereira I, Pinheiro G, Pinheiro M, Sauma M, Silva M, Toledo R, Valin V, Vieira W, Baaklini C, Descalzo M. SAT0362 Incidence of Adverse Events in Patients with Rheumatoid Arthritis and Spondyloarthritis Exposed to Anti-Tnf Therapy. Data from the Brazilian Registry for Monitoring of Biologic Therapies in Rheumatic Diseases (Biobadabrasil). Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.1572] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Riachy M, Baaklini C, Ibrahim I, Azar H, Yaghi C, Dabar G, Bazarbachi T, Nasnas R, Karam-Sarkis D, Germanos M, Maacaron N, Khayat G, Choucair J. [Acute respiratory distress syndrome complicating Ebstein-Barr virus pneumonia]. Rev Mal Respir 2007; 24:639-43. [PMID: 17519818 PMCID: PMC7135276 DOI: 10.1016/s0761-8425(07)91134-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Introduction Chez l’adulte immunocompétent, l’Epstein Barr (EBV) entraîne une maladie autolimitée spontanément résolutive. Observation Un syndrome de détresse respiratoire aigu (SDRA) compliquant une pneumonie grave à EBV est rapporté avec le recours à une ventilation artificielle prolongée. Le diagnostic était confirmé par l’usage des sérologies spécifiques et la recherche de la charge d’ADN virale par PCR. À part la stratégie protectrice de la ventilation mécanique, le traitement médical a compris l’utilisation de l’Acyclovir et les immunoglobulines polyclonales dans la phase précoce ainsi que des corticoïdes systémiques dans la phase tardive. La guérison était progressive et complète. Conclusion La pneumonie à EBV compliquée d’un SDRA chez les immunocompétents existe. Sa prise en charge est un défi diagnostique et thérapeutique.
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Affiliation(s)
- M Riachy
- Service de Pneumologie et de Réanimation Médicale, Hôtel Dieu de France, Beyrouth, Liban.
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