Consistent with virtue theory, some individuals' reports were indicative of a probabilistic tendency toward compassion, and ESM compassion predicted ESM eudaimonia and pro-social behavior toward those in need.
When measured at a section near the orbital apex, the mean combined muscle/summated soft tissue volume ratio and the mean superior rectus-levator complex/summated soft tissue volume ratio are greater in those with compressive disease than those without. This suggests that the specific enlargement of the superior rectus-levator complex makes a significant contribution to thyroid eye disease-compressive optic neuropathy and may explain the inferior visual field deficits classically found in this group of patients.
the right internal capsule and left frontal premotor area that were believed to be secondary to vasospasm. He was started on a 2-week prophylactic dose of intravenous vancomycin and meropenem. The psychiatric team evaluated him for psychosis and seizures and started him on valproate and olanzapine. The patient remained intubated in the intensive care unit for 1 month, after which he was transferred to the neurological ward for continuation of care. During a lengthy 6-month admission, the patient showed severe cognitive impairment and was discharged to a supervised nursing home for further treatment and care.
DISCUSSIONOver 50 cases of unilateral or bilateral psychotic oedipism have been reported in the last 50 years. [9][10][11][12][13] Most cases were in association with psychotic episodes, mainly untreated schizophrenia. 14 In this article, we report the first case of cocaine-induced self-enucleation in a healthy male with no known history of psychiatric disease, as well as another case of simultaneous bilateral selfenucleation in a patient with untreated schizophrenia. Self-enucleation is a rare ophthalmic and psychiatric emergency requiring immediate attention and collaboration between the ophthalmologist and the psychiatrist because it results in severe ophthalmic and possibly lethal neurological complications. Patients should be admitted, started on prophylactic antibiotics, and assessed by psychiatry. Continuous nursing supervision is warranted, particularly for patients with unilateral ocular damage. These patients are at a higher risk for further selfmutilation. Long-term psychiatric hospital admission and therapy may be necessary because these patients are at risk of suicide. 15
This article examines the effectiveness of skin-muscle flap excision in conjunction with a lateral tarsal strip for the treatment of involutional entropion. Ninety-six eyelids in 83 consecutive patients with involutional entropion were treated using a standardized surgical procedure. All patients underwent lower eyelid tightening with a lateral tarsal strip, dissection of a skin-muscle flap inferiorly through a subciliary incision and excision of redundant skin as well as orbicularis muscle. Follow-up data was obtained by retrospective chart review and telephone interviews. 80 patients were included in this study. The only exclusion criteria was failure to attend the 1 week follow-up appointment, n = 3. There was only one recurrence which was mild and revised under local anesthesia. Two patients had overcorrection with mild ectropion but did not require additional surgery. In those that completed their initial post-operative visit, the average time follow-up time was 502 days. Excision of a skin-muscle flap is a useful addition to lateral tarsal strip surgery in the treatment of involutional entropion and is a quick procedure producing excellent functional and cosmetic results. To our knowledge, this is the first cohort of patients to be reported using this technique where all patients had a standardized surgical approach. Additional studies are needed to compare long-term outcomes of this technique against other surgical treatments.
The authors describe a 9-year-old female who presented with swelling, proptosis, and tenderness of the right upper eyelid and MRI imaging demonstrating right lacrimal gland enlargement. After failing treatment with corticosteroids, the patient underwent a biopsy that was consistent with IgG4-related orbital disease. She was subsequently successfully treated with adalimumab (TNF-α inhibitor). This is the first case report of the successful use of a TNF-α inhibitor for the treatment of IgG4-related orbital disease in a child.
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