scholarly journals Mechanical injuries of the eyeball: Frequency, structure, and possibility of the prevention

2006 ◽  
Vol 134 (1-2) ◽  
pp. 11-21 ◽  
Author(s):  
Milos Jovanovic
Keyword(s):  
Visual Acuity ◽  
Term Treatment ◽  
Wound Management ◽  
Working Population ◽  
Eye Injuries ◽  
Penetrating Injuries ◽  
Permanent Disability ◽  
Study Objective ◽  
Long Term Treatment ◽  
The Right

Introduction. Some factors significant for development of mechanical injuries of the eyeball have been analyzed in the study. Objective. Basic objective of such analysis was prevention and reduction of these injuries. Method. Mechanical injuries of the eyeball in patients hospitalized at the Institute of Eye Disease, CCS in Belgrade, in five year period have been analyzed. Only patients with severe eye injuries were hospitalized. The following parameters were analyzed: sex, age, occupation of patients, residence, time of the inflicted injury, i.e. by months in a year, days in a week and hours in a day, place and way of inflicting the injury as well as visual acuity on admission. In addition, the type of injury was analyzed, i.e. contusion or penetrating with all resulting complications. Finally, the timing of primary surgical management of the eye injury was specified, if required. Results. A total number of hospitalized patients with mechanical eye injuries was 1642 during the last five years, meaning that one injury occurred daily. There were 1381 males and 261 females, meaning that males were 5.3 times more the victims of mechanical eye injuries. Out of all the injured, 861 (52.4%) were from rural environment, while 781 (47.6%) were urban population. The proportion of injuries of the right or the left eye was nearly equal, while both eyes were simultaneously injured in 21 (1.3%) cases. The injuries were inflicted in all ages, but most frequently in working population ranging from 16 to 55 years, accounting for 60.8%. Unfortunately, a lot of the injured were children up to 15 years of age - 19.4%. The most commonly injured were workers - 39.8%, followed by students - 17.5%. A piece of wood was the cause of injury in 21.8%, sharp and pointed objects in 17.2%, hammer and metal in 14.2%, glass in 11.6%, and other different causes in varying percentage. There were also rare causes of injuries, such as those caused by zip, dog bite, rooster?s bill, etc. According to months in a year and days in a week, the injuries were almost evenly distributed. Considering the period of a day, even 77.4% of the injuries occurred during daytime, from 10 a.m. to 10 p.m. The highest percentage - 43.5% - of the injuries occurred while working something out of working place, while 24.5% of injuries were inflicted at working places. On admission, the majority of patients - 32.9% had visual acuity L+P+, but this visual acuity ranged from amaurosis to 1.0. There were 746 (45.4%) contusion injuries and 870 (53.0%) penetrating injuries. The rest were the injuries of other ocular adnexa. The majority of primary wound managements were performed in the first 24 hours of the injury - 67.1%. Conclusion. It may be concluded that working population and students are most commonly injured, and that men are five times more frequently injured than women; then, a piece of wood, sharp objects and glass are the most often causes of injury; the number of contusion and penetrating injuries is equal, and that required primary surgical wound management is most often performed in the first 24 hours from the injury. Further analysis of these factors suggests that many of these injuries could have been prevented, and consequently long-term treatment and treatment costs could have been evaded. Most important is that permanent disability due to visual impairment or even blindness of the injured eye could have been avoided.

scholarly journals Cardiovascular and cerebrovascular risk with nonsteroidal anti-inflammatory drugs and cyclooxygenase 2 inhibitors: latest evidence and clinical implications

2017 ◽  
Vol 8 (6) ◽  
pp. 173-182 ◽  
Author(s):  
Andrea Fanelli ◽  
Daniela Ghisi ◽  
Pierangelo Lora Aprile ◽  
Francesco Lapi
Keyword(s):  
Term Treatment ◽  
Cyclooxygenase 2 ◽  
Thrombotic Risk ◽  
Long Term Treatment ◽  
Pressure Development ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
High Doses ◽  
The Right ◽  
Meta Analyses

Observational studies and meta-analyses have shown that the administration of nonsteroidal anti-inflammatory drugs (NSAIDs), especially when prescribed at high doses for long periods of time, can potentially increase the risk of cardiovascular diseases. The increased thrombotic risk related to the use of NSAIDs is mainly due to their cyclooxygenase 2 selectivity. The dosage use, the formulation selected and the duration of the therapy are other factors that can significantly impact on the cardiovascular risk. In order to minimize the risk, prescription of the right drug based on the patient’s features and the different safety profiles of several NSAIDs that are available on the market is key for their appropriate administration. Despite the baseline cardiovascular and gastrointestinal risk of each patient, monitoring of patients is suggested for increases in blood pressure, development of edema, deterioration of renal function, or gastrointestinal bleeding during long-term treatment with NSAIDs.

scholarly journals A rare case of bilateral obstructive megaureter with a giant uretal ureterocele on the left

2020 ◽  
Vol 24 (3) ◽  
pp. 205-209
Author(s):  
G. N. Rumyantseva ◽  
V. N. Kartashev ◽  
Marina V. Dolinina ◽  
I. B. Osipov ◽  
A. I. Osipov ◽  
...  
Keyword(s):  
Left Kidney ◽  
Boarding School ◽  
Term Treatment ◽  
Ectopic Ureterocele ◽  
Surgical Department ◽  
Long Term Treatment ◽  
Obstructive Megaureter ◽  
The Right ◽  
Medical University

The article discusses a case of 4-year-old patient with a bilateral obstructive megaureter of a non-functioning left kidney and with the opening of this kidney ureter into the urethra with extravasal location of a giant ureterocele. The malformation of the urinary system was accompanied by a comorbid disease of bronchopulmonary system in the form of tuberculosis of the lungs and intra-thoracic lymph nodes. At the age of one month, due to decompensation of the only functioning right kidney, urine was withdrawn by applying a ureterostomy. Later, a proximal lateral cutaneous ureterostomy was put because of social reasons (mother refused of her baby). In two months, the next step was performed - a ureterocystoneostomy by the Cohen’s antireflux technique. After a long-term treatment for tuberculosis in clinics of Tver and St. Petersburg, at the age of 4, the girl was operated on at the first surgical department at St-Petersburg State Pediatric Medical University. Laparoscopic nephroureterectomy on the left with conversion to lower-middle laparotomy and resection of the terminal part of the left ureter with a giant ectopic ureterocele as well as closure of the ureterocutaneostomy on the right were performed. After stabilization, the child was transferred to a children’s boarding school in Tver, and currently is supervised by pediatric urologists and TB specialists.

scholarly journals Extensive skull base osteomyelitis, devastating complication of otitis externa: A case report and review of the literature

2021 ◽  
Vol 2 (3) ◽  
pp. 1-7
Author(s):  
Khadija El Bouhmadi ◽  
◽  
Myriam Loudghiri ◽  
Youssef Oukessou ◽  
Sami Rouadi ◽  
...  
Keyword(s):  
Skull Base ◽  
Otitis Externa ◽  
Delayed Diagnosis ◽  
Petrous Bone ◽  
Term Treatment ◽  
Skull Base Osteomyelitis ◽  
Long Term Treatment ◽  
Orbital Wall ◽  
The Right

Skull base osteomyelitis (SBO), also referred to as malignant otitis externa (MOE) in its typical form, is usually a complication of otitis externa and severe uncommon and life-threatening condition requiring early diagnosis and long-term treatment in order to avoid its neurologic sequelae. We report the case of 69 years old female with a history of uncontrolled type 2 diabetes, who presented refractory and chronic right-sided purulent otorrhea with temporal headaches for 6 months, treated with no improvement by multiple attempts of ambulatory empiric therapy. After the appearance of grade III facial palsy and painful swelling in the right periorbital and zygomatic areas, the patient consulted in our department where a CT scan showed massive cortical and trabecular destruction of the right petrous bone and the mastoid extended to the lateral orbital wall, the zygomatic arch and the greater sphenoid wing realising extensive osteomyelitis of the skull base and the lateral face. The treatment was started immediately based on intravenous broad-spectrum antibiotics. Despite aggressive long-term treatment, the patient passed away, underlying the increased SBO morbidity and mortality secondary to delayed diagnosis.

scholarly journals Dystrophic Calcifications in the Breast from Secondary Hyperparathyroidism

Breast Care ◽  
2017 ◽  
Vol 13 (1) ◽  
pp. 44-46 ◽  
Author(s):  
Kyoung Min Lee ◽  
Jee Eun Lee ◽  
Eun Suk Cha ◽  
Jin Chung ◽  
Jeoung Hyun Kim ◽  
...  
Keyword(s):  
Secondary Hyperparathyroidism ◽  
Correct Diagnosis ◽  
Term Treatment ◽  
Dystrophic Calcification ◽  
Palpable Mass ◽  
Long Term Treatment ◽  
History Of ◽  
The Right ◽  
Stage Renal Disease ◽  
End Stage

Background: Soft tissue calcification is common in patients with secondary hyperparathyroidism who have received long-term treatment with hemodialysis. However, calcifications in the breast parenchyma are not common. We report a case of a woman with dystrophic breast calcifications from secondary hyperparathyroidism. Case Report: A 65-year-old woman presented with a palpable mass in her right breast which she had discovered 1 month ago. She had a medical history of end-stage renal disease. Mammography and ultrasound revealed large dystrophic calcifications in both breasts. Core needle biopsy was performed for calcifications in the right breast, and the pathologic diagnosis was dystrophic calcification in the stroma from secondary hyperparathyroidism. Conclusion: Reviewing our case will contribute to a fast and correct diagnosis in patients with dystrophic breast calcifications and lab results indicating secondary hyperparathyroidism, and will help discriminate these benign lesions from malignancies.

scholarly journals Sex- and region-biased depletion of microglia/macrophages attenuates CLN1 disease in mice

2020 ◽  
Vol 17 (1) ◽  
Author(s):  
Kristina Berve ◽  
Brian L. West ◽  
Rudolf Martini ◽  
Janos Groh
Keyword(s):  
Visual Acuity ◽  
Immune Cells ◽  
Term Treatment ◽  
Innate Immune ◽  
Neuronal Ceroid Lipofuscinoses ◽  
Innate Immune Cells ◽  
Immune Reactions ◽  
Neuron Loss ◽  
Long Term Treatment

Abstract Background The neuronal ceroid lipofuscinoses (CLN diseases) are fatal lysosomal storage diseases causing neurodegeneration in the CNS. We have previously shown that neuroinflammation comprising innate and adaptive immune reactions drives axonal damage and neuron loss in the CNS of palmitoyl protein thioesterase 1-deficient (Ppt1−/−) mice, a model of the infantile form of the diseases (CLN1). Therefore, we here explore whether pharmacological targeting of innate immune cells modifies disease outcome in CLN1 mice. Methods We applied treatment with PLX3397 (150 ppm in the chow), a potent inhibitor of the colony stimulating factor-1 receptor (CSF-1R) to target innate immune cells in CLN1 mice. Experimental long-term treatment was non-invasively monitored by longitudinal optical coherence tomography and rotarod analysis, as well as analysis of visual acuity, myoclonic jerks, and survival. Treatment effects regarding neuroinflammation, neural damage, and neurodegeneration were subsequently analyzed by histology and immunohistochemistry. Results We show that PLX3397 treatment attenuates neuroinflammation in CLN1 mice by depleting pro-inflammatory microglia/macrophages. This leads to a reduction of T lymphocyte recruitment, an amelioration of axon damage and neuron loss in the retinotectal system, as well as reduced thinning of the inner retina and total brain atrophy. Accordingly, long-term treatment with the inhibitor also ameliorates clinical outcomes in CLN1 mice, such as impaired motor coordination, visual acuity, and myoclonic jerks. However, we detected a sex- and region-biased efficacy of CSF-1R inhibition, with male microglia/macrophages showing higher responsiveness toward depletion, especially in the gray matter of the CNS. This results in a better treatment outcome in male Ppt1−/− mice regarding some histopathological and clinical readouts and reflects heterogeneity of innate immune reactions in the diseased CNS. Conclusions Our results demonstrate a detrimental impact of innate immune reactions in the CNS of CLN1 mice. These findings provide insights into CLN pathogenesis and may guide in the design of immunomodulatory treatment strategies.

Intravitreal bevacizumab monotherapy in myopic choroidal neovascularisation: 5-year outcomes for the PAN-American Collaborative Retina Study Group

2017 ◽  
Vol 102 (4) ◽  
pp. 455-459 ◽  
Author(s):  
Jay Chhablani ◽  
Remya Mareen Paulose ◽  
Andres F Lasave ◽  
Lihteh Wu ◽  
Cristian Carpentier ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Adverse Events ◽  
Real Life ◽  
Intravitreal Bevacizumab ◽  
Term Treatment ◽  
Choroidal Neovascularisation ◽  
Long Term Treatment ◽  
The Mean

PurposeTo report the long-term anatomical and visual outcomes of intravitreal bevacizumab (IVB) monotherapy in naive choroidal neovascularisation (CNV) caused by myopia.MethodsRetrospective analysis of naive CNV secondary to myopia that underwent antivascular endothelial growth factor monotherapy was performed. Collected data included demographic details, clinical examination details including visual acuity at presentation and follow-up with imaging and treatment details. Main outcome measures were resolution of CNV activity at the last visit. Secondary outcomes included change in visual acuity, number of injections and adverse events.ResultsThirty-three eyes of 31 subjects with a mean age of 51.48±16.4 years were included. The mean follow-up was 66.47 months. 27 eyes had type 2 CNV and the rest seven eyes had type 1 CNV. The mean number of IVB injections per eye was 4.9. Mean visual acuity at baseline reduced from 0.65±0.33 logMAR units (Snellen equivalent=20/89) to 0.73±0.50 logMAR units (20/107) at final follow-up (p=0.003). The mean central macular thickness decreased from 309.31±86 µm at baseline to 267.5±70.89 µm at the last visit (p=0.03). However, visual acuity was maintained (±1 line of baseline) in 13 eyes (39.4%), ≥2 line improvement in nine (27.3%) eyes and more than two lines worsening in 11 eyes (33.3%). Foveal atrophy was observed at baseline and last visit in 6 (12.5%) and 14 (29.1%), respectively (p=0.007). No systemic adverse events were observed.ConclusionIVB monotherapy is safe and effective for long-term treatment of CNV secondary to myopia in real life.

An Alternative View of a Hemodialysis–Life Balance: Life Reorganization of Korean Patients Undergoing Hemodialysis

2021 ◽  
pp. 104365962098833
Author(s):  
Songsoon Kim ◽  
Jinhyang Yang
Keyword(s):  
Comparative Method ◽  
Belief System ◽  
Hemodialysis Patients ◽  
Term Treatment ◽  
Alternative View ◽  
Negative Experience ◽  
Life Balance ◽  
Individual Interviews ◽  
Long Term Treatment ◽  
The Right

Introduction: Hemodialysis patients in Korea increased 2.3 fold from 2008 to 2018 and continues to rise 7% to 10% annually. Long-term treatment to prevent complications requires understanding patients’ hemodialysis–life balance. Our purpose was to explore the process of life reorganization by hemodialysis patients from Korea. Method: Grounded theory methodology was utilized. Participants were hemodialysis patients recruited from four hemodialysis centers in Korea. Data were collected by in-depth individual interviews. Data were analyzed using constant comparative method with theoretical saturation. Results: Participants ( n = 14) experienced four phases with transitions. A traditional Korean belief system, the view of blessing-focused destiny promoted a change in perspective from the focus on a life crisis, and thereby, played a role in buffering negative experience. Discussion: Nurses should assess the cultural individual needs of patients, which change according to each phase of life reorganization, and provide the right care at the right time to increase positive experiences.

scholarly journals Restoring voice function after open diagonal resection of the larynx

2019 ◽  
Vol 8 (4) ◽  
pp. 32-38
Author(s):  
A. L. Kozhanov ◽  
L. G. Kozhanov ◽  
V. N. Sorokin ◽  
E. S. Romanova
Keyword(s):  
Laryngeal Cancer ◽  
Acoustic Analysis ◽  
Term Treatment ◽  
Healthy Individuals ◽  
Acoustic Characteristics ◽  
Study Objective ◽  
Breathing Exercises ◽  
Speech Rehabilitation ◽  
Long Term Treatment ◽  
Voice Fundamental Frequency

The study objective is to perform the acoustic analysis of voice in patients after open diagonal resection of the larynx.Materials and methods. A total of 112 patients underwent diagonal resection of the larynx; of them 73 hadfrontolateral resection and 39 had expanded frontolateral resection. Primary laryngeal cancer was diagnosed in 107 patients; five patients had relapses after radiation therapy. Fifty-six participants underwent acoustic analysis of voice before surgery, 52 participants underwent it 1 month postoperatively, and 112 participants had it after completing their rehabilitation (6 months to 10 years postoperatively). To determine normal acoustic characteristics of voice, we examined 80 men with normal voice. We measured voice fundamental frequency (FF), maximum and minimum FF, FF variability, jitter, shimmer, voice intensity, amplitude of fundamental tone’s harmonics and their difference. Speech rehabilitation included breathing exercises according to E. Ya. Zolotareva and speech training according to S.L. Taptapova.Results. Patients with laryngeal cancer demonstrated significant changes in the acoustic characteristics of their voice (p <0.05) compared to healthy individuals, including increased mean FF (f0) (up to 143 ± 45 Hz vs 118 ± 18 Hz in controls), decreased voice intensity (from 60 ± 8 to 43 ± 8 dB), and almost 2-fold decrease in the amplitude of fundamental tone’s harmonics (ω0, 2 ω0, 3 ω0). We also found an increased dispersion and variability of acoustic characteristics assessed compared to healthy individuals. The analysis of long-term treatment outcomes demonstrated more significant improvement of voice acoustic characteristics in patients who underwent speech rehabilitation compared to those who had no rehabilitation.Conclusion. Open resection of the larynx with endoscopic removal of granulations and ligatures and laser restoration of the laryngeal lumen by dissecting the scars complemented by speech rehabilitation allow restoring respiratory function in 91.1 % of patients and restoring voice in 91.8 % of patients (to achieve acoustic characteristics close to normal).

Atrial flutter: management

ESC CardioMed ◽  
2018 ◽  
pp. 2211-2217
Author(s):  
Tilman Maurer ◽  
Christine Lemes ◽  
Karl-Heinz Kuck
Keyword(s):  
Atrial Flutter ◽  
Structural Heart Disease ◽  
Term Treatment ◽  
Non Invasive ◽  
Surface Ecg ◽  
Long Term Treatment ◽  
The Common ◽  
The Right ◽  
Electrocardiogram Ecg

Atrial flutter (AFL) is the most common macroreentry tachycardia in patients with and without structural heart disease. In the majority of cases, the arrhythmia is associated with a pre-existing comorbidity such as heart failure or lung disease. AFL refers to an electrocardiogram (ECG) pattern of a regular tachycardia with an atrial rate of more than 240 beats per minute and a lack of an isoelectric baseline between deflections. The most frequent form is termed ‘common’ or ‘typical’ if biphasic waves are present in the inferior leads, resembling a ‘saw-tooth’ pattern. Common AFL is diagnosed in 90% of cases and its mechanism is a macroreentry within the right atrium involving the cavotricuspid isthmus. ‘Atypical’ AFL refers to any ECG flutter morphology different from the common type. While the surface ECG provides a widely available and non-invasive diagnostic tool, a definite diagnosis of the underlying tachycardia mechanism can only be established by invasive electrophysiological testing. Acute management of AFL includes measures for rate control by pharmacological treatment or rhythm control by antiarrhythmic drugs or electrical cardioversion. For long-term treatment, catheter ablation offers a safe, effective, and curative approach for common flutter and is also a treatment option for atypical AFL. Anticoagulation should be initiated according to risk stratification based on the CHA2DS2-VASc score to prevent thromboembolic complications. This chapter provides a detailed overview on the pathophysiology and electrocardiographic characteristics of AFL and discusses the clinical management of the arrhythmia.

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