scholarly journals The contribution of A. Gref to clinical ophthalmology (to the 190th anniversary of the birth)

2018 ◽  
Vol 20 (2) ◽  
pp. 268-271
Author(s):  
T Sh Morgoshiia ◽  
V Ya Apchel
Keyword(s):  
Clinical Practice ◽  
Drug Treatment ◽  
Optic Neuritis ◽  
Clinical Manifestations ◽  
Scientific Work ◽  
Muscle Paralysis ◽  
Retinal Artery ◽  
Eye Pressure ◽  
Hermann Helmholtz ◽  
Linear Cut

The first scientific and practices works in ophthalmology of Professor Albreht Grephe are possibilities. Notes, that in 1850 Hermann Helmholtz introduced the ophthalmoscope into clinical practice, this tool allowed Albrecht Gref to make a number of discoveries and scientific proposals concerning the pathology of the fundus. He described the embolism of the retinal artery, differentiated central recurrent syphilitic retinitis from diffuse, described optic neuritis and much more. Seven years of his scientific work, A. Gref has devoted to the study of the functioning of the eye muscles, strabismus and its correction by surgery, the study of amblyopia. Later, he described in detail the symptoms of ocular muscle paralysis and the clinical manifestations of diphtheria and benign renal conjunctivitis, outlined the ways of drug treatment of these diseases. Gref considered eye pressure the main cause of glaucoma. In his opinion, reducing pressure, it was possible to save the patient from glaucoma. During the treatment of the patient with complete infection of the pupil, A. Grefe made iridectomy (excision of the iris part) and noticed that the eye after the operation became softer. This prompted the doctor to think about the possibility of using such an operation for glaucoma. It is important to note that at the first International Ophthalmological Congress in Brussels in 1857 Gref made a report «On the nature and treatment of glaucoma by iridectomy». This operation brought him world fame and saved many glaucoma patients from blindness. Iridectomy is used in ophthalmic practice and at the present time. In 1859 Grefe proposed a method for peripheral linear extraction of cataracts. He made a peripheral linear cut, thanks to which the divergence of the edges of the wound of the patch cut was eliminated. For such a cut Grefe invented a special long and narrow scalpel, behind which the name Grefevsky was preserved. As time has shown, the basic theoretical and practical provisions and discoveries of Grefe still form the foundation of our knowledge in ophthalmology.

Disseminated intravascular coagulation syndrome

2020 ◽  
pp. 22-40
Author(s):  
A. Kulikov
Keyword(s):  
Clinical Practice ◽  
Disseminated Intravascular Coagulation ◽  
Blood Cells ◽  
Physical State ◽  
Clinical Manifestations ◽  
Vascular Wall ◽  
Stages Of Development ◽  
Intravascular Coagulation ◽  
Hemostatic Disorder

Presented material reveals main links in the pathogenesis of hemostatic disorder. In particular, attention is paid to the role of the lungs, liver and other organs in the development of this process. Role of vascular wall and blood cells in regulation of the physical state of blood is described in detail. The most frequent factors leading to hypercoagulation are indicated. Difference between hypercoagulation and thrombophilia is shown. The latter is found in clinical practice quite often, but at the same time, it is poorly diagnosed. Such a terrible complication of hemostatic disorder as disseminated intravascular coagulation is described. Its classification, stages of development, clinical manifestations are offered to the readers.

scholarly journals Neuralgic amyotrophy: an underrecognized entity

2021 ◽  
Vol 49 (4) ◽  
pp. 030006052110065
Author(s):  
Tae Uk Kim ◽  
Min Cheol Chang
Keyword(s):  
Clinical Practice ◽  
Magnetic Resonance ◽  
Clinical Manifestations ◽  
Clinical History ◽  
Cervical Radiculopathy ◽  
Sudden Onset ◽  
Clinical Findings ◽  
Magnetic Resonance Neurography ◽  
Essential Information ◽  
Neuralgic Amyotrophy

Neuralgic amyotrophy (NA) is markedly underdiagnosed in clinical practice, and its actual incidence rate is about 1 per 1000 per year. In the current article, we provide an overview of essential information about NA, including the etiology, clinical manifestations, diagnostic investigations, differential diagnosis, treatment, and prognosis. The causes of NA are multifactorial and include immunological, mechanical, or genetic factors. Typical clinical findings are a sudden onset of pain in the shoulder region, followed by patchy flaccid paralysis of muscles in the shoulder and/or arm. A diagnosis of NA is based on a patient’s clinical history and physical examination. Gadolinium-enhanced magnetic resonance imaging and high-resolution magnetic resonance neurography are useful for confirming the diagnosis and choosing the appropriate treatment. However, before a diagnosis of NA is confirmed, other disorders with similar symptoms, such as cervical radiculopathy or rotator cuff tear, need to be ruled out. The prognosis of NA depends on the degree of axonal damage. In conclusion, many patients with motor weakness and pain are encountered in clinical practice, and some of these patients will exhibit NA. It is important that clinicians understand the key features of this disorder to avoid misdiagnosis.

scholarly journals Noncompaction Cardiomyopathy—History and Current Knowledge for Clinical Practice

2021 ◽  
Vol 10 (11) ◽  
pp. 2457
Author(s):  
Birgit J. Gerecke ◽  
Rolf Engberding
Keyword(s):  
Clinical Practice ◽  
Current Knowledge ◽  
Clinical Manifestations ◽  
Clinical Patient ◽  
Noncompaction Cardiomyopathy ◽  
The Past ◽  
Wide Range ◽  
Morphological Variants ◽  
A Current ◽  
Healthy Persons

Noncompaction cardiomyopathy (NCCM) has gained increasing attention over the past twenty years, but in daily clinical practice NCCM is still rarely considered. So far, there are no generally accepted diagnostic criteria and some groups even refuse to acknowledge it as a distinct cardiomyopathy, and grade it as a variant of dilated cardiomyopathy or a morphological trait of different conditions. A wide range of morphological variants have been observed even in healthy persons, suggesting that pathologic remodeling and physiologic adaptation have to be differentiated in cases where this spongy myocardial pattern is encountered. Recent studies have uncovered numerous new pathogenetic and pathophysiologic aspects of this elusive cardiomyopathy, but a current summary and evaluation of clinical patient management are still lacking, especially to avoid mis- and overdiagnosis. Addressing this issue, this article provides an up to date overview of the current knowledge in classification, pathogenesis, pathophysiology, epidemiology, clinical manifestations and diagnostic evaluation, including genetic testing, treatment and prognosis of NCCM.

Concrescence of the cervical vertebrae and neurological complications

2021 ◽  
pp. 195-201
Author(s):  
Sabiyat Abdulaevna Yakhyaeva ◽  
Naida Isagadzhievna Garabova ◽  
Madina Garunovna Burzhunova
Keyword(s):  
Cervical Spine ◽  
Clinical Practice ◽  
Research Methods ◽  
Neurological Disorders ◽  
Cervical Vertebrae ◽  
Clinical Manifestations ◽  
Neurological Complications ◽  
Timely Diagnosis ◽  
Number Of Patients ◽  
Genetically Determined

In clinical practice, a sufficiently large number of patients complain of neurological disorders caused by osteochondrosis of the cervical spine. Despite this, in some cases, the development and progression of this symptomatology may be due to an anomaly in the structure of the cervical spine (Klippel-Feil syndrome), which is genetically determined. Timely diagnosis of this pathology with the implementation of complex research methods allows you to develop individual tactics for each individual patient, taking into account the severity of clinical manifestations to slow the progression of complications.

scholarly journals Case report of von willebrand disease after tonsillotomy and adenotomy in a child

2021 ◽  
Vol 20 (1) ◽  
pp. 89-92
Author(s):  
S. S. Makhmudov ◽  
◽  
A. A. Ochilzoda ◽  
F. P. Dzhamolov ◽  
A. Z. Mutalibov ◽  
...  
Keyword(s):  
Case Report ◽  
Clinical Practice ◽  
Surgical Treatment ◽  
Clinical Case ◽  
Clinical Manifestations ◽  
Von Willebrand Disease ◽  
Rare Occurrence ◽  
Von Willebrand

The authors present a clinical case of von Willebrand disease detected after tonsillotomy and adenotomy in a child. The peculiarity of this observation lies in the rare occurrence of von Willebrand disease in clinical practice, as well as the manifestation of the clinical manifestations of this pathology against the background of surgical treatment in a child.

scholarly journals CLINICAL PROFILE AND MANAGEMENT OF PATIENTS OF AMOEBIC LIVER ABSCESS IN A TERTIARY CARE CENTRE

2020 ◽  
pp. 5-7
Author(s):  
Rakesh Mishra ◽  
Debabrata Banerjee ◽  
Debarshi Jana
Keyword(s):  
Drug Treatment ◽  
Liver Abscess ◽  
Tertiary Care ◽  
Clinical Manifestations ◽  
Needle Aspiration ◽  
Intestinal Disease ◽  
Amoebic Liver Abscess ◽  
Treatment Modalities ◽  
Tertiary Care Centre ◽  
Early Recovery

Introduction: Amoebiasis is caused by the protozoan Entamoeba histolytica. Most infections are asymptomatic; clinical manifestations include amoebic dysentery and extra intestinal disease. Amoebic liver abscess is the most common extraintestinal manifestation of amoebiasis. Amoebae establish hepatic infection by ascending the portal venous system. Aim: To study various aspects of Amoebic Liver Abscess like demographic profiles, clinical presentations, association with intestinal disease, radiological and laboratory findings, treatment modalities and complications. Materials and Methods: A hospital based prospective observational study was performed in the Department of Internal Medicine, Command Hospital (Eastern Command), Kolkata, from Jan 2018 to Jun 2019. All confirmed cases of amoebic liver abscess above the age of 18 years admitted in Command Hospital (EC) were included in this study. The patient were then subsequently followed up for 01 year with USG abdomen every 03 monthly. Results: Total 40 patients of Amoebic Liver Abscess with age more than 18 year were enrolled in the study. The age ranged from 26 to 70 years (mean age 46.2 year). Male patients were dominated over female. 80.0 % were from rural background. About 55% patients were addicted to alcohol & 25.0 % were known diabetics at presentation. In all, 07 (17.5%) patients with abscess size of 6 cm to 10 cm (Vol> 300 cc) were treated by needle aspiration and drug therapy. Remaining 17(42.5%) patients with abscess size more than 10 cm were treated with pigtail drainage and drug. Conclusion: There is significant advantage of pigtail drainage with drug treatment over needle aspiration with drug and only with drug treatment in terms of decrease in lesion size and early recovery.

7P pediatrics — Medicine of Development and Health Programming

2021 ◽  
Vol 76 (6) ◽  
pp. 622-634
Author(s):  
Leyla S. Namazova-Baranova ◽  
Alexandr A. Baranov ◽  
Elena A. Vishneva ◽  
Anna A. Alekseeva ◽  
Valerii Y. Albitskiy ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Information And Communication Technologies ◽  
Scientific Work ◽  
Educational Process ◽  
Educational Support ◽  
Progressive Development ◽  
Fundamental Science ◽  
Fundamental Medicine ◽  
Health Programming ◽  
Medical Process

The transition to personalized, predictive, preventive and participatory medicine, due, among other things, to the achievements of fundamental science, digitalization and the development of information and communication technologies, naturally demanded changes in childrens health care. New organizational, methodological and technological changes that have taken place to ensure a highly dynamic, adapted, and, at the same time, permanent provision of the medical process anywhere and at any time, have led to the need for specialists of a new formation a pluriexpert team ready to work in new conditions: how to participate in research in fundamental science, and to the introduction of innovative methods in clinical practice, medical and social support and the educational process. In these conditions, the strategic goal set for pediatrics to analyze absolutely all aspects of health: somatic, neuropsychic, emotional and psycho-social, in the process of growth and development of a child from conception/birth to adolescence / adulthood was implemented in a new direction of clinical and fundamental medicine developmental pediatrics and child health programming. 7P-pediatrics: Programming the development and health of the child, Preventive, Predictive, Personalized, Participatory, Polyprofessional (Pluriexpert), Progressive medicine for children, in which the results of scientific work based on fundamental data and ideas of neurosciences about progressive development and modern methodology of educational support of the entire medical process are fully translated into a clinical practice.

Platelet Function Disorders

2017 ◽  
pp. 117-137
Author(s):  
Zubair A. Karim ◽  
Fadi T. Khasawneh
Keyword(s):  
Clinical Practice ◽  
Molecular Characterization ◽  
Platelet Function ◽  
Clinical Manifestations ◽  
Functional Responses ◽  
Platelet Function Disorders ◽  
Coagulant Activity ◽  
Common Causes ◽  
Adp Receptor

Platelets play an important role in thrombosis and hemostasis. Moreover, platelet dysfunction due to congenital and acquired etiologies is also one of the most common causes of bleeding encountered in clinical practice. Mostly, platelet function disorders are deficiencies of glycoprotein mediators of adhesion and aggregation, whereas defects of primary receptors for stimuli include those of the P2Y12 ADP receptor. Studies on inherited defects of (1) secretion for storage organelles (dense and alpha-granules), (2) the platelet cytoskeleton, and (3) the generation of pro-coagulant activity have allowed for the identification of genes directly and/or indirectly controlling specific functional responses. This chapter will review recent advances in the molecular characterization of platelet function defects, the spectrum of clinical manifestations of these disorders and their management.

scholarly journals Cost-Effectiveness of Drug Treatment for Chinese Patients With Stage I Hypertension According to the 2017 Hypertension Clinical Practice Guidelines

Hypertension ◽  
2020 ◽  
Vol 76 (3) ◽  
pp. 750-758
Author(s):  
Yan-Feng Zhou ◽  
Na Liu ◽  
Pei Wang ◽  
Jae Jeong Yang ◽  
Xing-Yue Song ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Clinical Practice ◽  
Drug Treatment ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Cost Effective ◽  
Stage I ◽  
Chinese Patients ◽  
Lifetime Horizon ◽  
Hypertensive Patients

Systolic/diastolic blood pressure of 130 to 139/80 to 89 mm Hg has been defined as stage I hypertension by the 2017 Hypertension Clinical Practice Guidelines. Drug treatment is recommended for stage I hypertensive patients aged ≥65 years without cardiovascular disease in the 2017 Hypertension Clinical Practice Guidelines but not in the 2018 Chinese guidelines. However, the cost-effectiveness of drug treatment among this subgroup of Chinese patients is unclear. This study developed a microsimulation model to compare costs and effectiveness of drug treatment and nondrug treatment for the subgroup of stage I hypertensive patients over a lifetime horizon from a government affordability perspective. Event rates of mortality and cardiovascular complications were estimated from 3 cohorts in the Chinese population. Costs and health utilities were obtained from the national statistics report and published literature. The model predicted that drug treatment generated quality-adjusted life-years of 13.52 and associated with expected costs of $6825 in comparison with 13.81 and $7328 produced by nondrug treatment over a lifetime horizon among stage I hypertensive patients aged ≥65 years without cardiovascular disease. At a willingness-to-pay threshold of $8836/quality-adjusted life-year (the GDP per capita in 2017), drug treatment only had a 1.8% probability of being cost-effective compared with nondrug treatment after 10 000 probabilistic simulations. Sensitivity analysis of treatment costs, benefits expected from treatment, health utilities, and discount rates did not change the results. Our results suggested that drug treatment was not cost-effective compared with nondrug treatment for stage I hypertensive patients aged ≥65 years without cardiovascular disease in China.

Cardiovascular genetics: the role of genetic testing in diagnosis and management of patients with hypertrophic cardiomyopathy

Heart ◽  
2020 ◽  
pp. heartjnl-2020-316798
Author(s):  
Monica Ahluwalia ◽  
Carolyn Y Ho
Keyword(s):  
At Risk ◽  
Clinical Practice ◽  
Genetic Testing ◽  
Hypertrophic Cardiomyopathy ◽  
Clinical Manifestations ◽  
Left Ventricular ◽  
Family Management ◽  
Panel Testing ◽  
Pathogenic Variants ◽  
Gene Panel Testing

Genetic testing in hypertrophic cardiomyopathy (HCM) is a valuable tool to manage patients and their families. Genetic testing can help inform diagnosis and differentiate HCM from other disorders that also result in increased left ventricular wall thickness, thereby directly impacting treatment. Moreover, genetic testing can definitively identify at-risk relatives and focus family management. Pathogenic variants in sarcomere and sarcomere-related genes have been implicated in causing HCM, and targeted gene panel testing is recommended for patients once a clinical diagnosis has been established. If a pathogenic or likely pathogenic variant is identified in a patient with HCM, predictive genetic testing is recommended for their at-risk relatives to determine who is at risk and to guide longitudinal screening and risk stratification. However, there are important challenges and considerations to implementing genetic testing in clinical practice. Genetic testing results can have psychological and other implications for patients and their families, emphasising the importance of genetic counselling before and after genetic testing. Determining the clinical relevance of genetic testing results is also complex and requires expertise in understanding of human genetic variation and clinical manifestations of the disease. In this review, we discuss the genetics of HCM and how to integrate genetic testing in clinical practice.

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