Senile eye cataract: medical and social aspects and the risk to public health

A review of literature data on issues related to the prevalence of cataract among the population and the possibilities of its treatment is provided. In 2010, there were more than 10,8 million people worldwide who completely lost their vision due to cataracts, and partially lost more than 35,1 million people. Currently, the growth rate of senile cataract is two times faster than the growth rate of the total population, and in industrialized countries - five times. The problem of the wide spread and severity of injury in cataracts, along with the medical one, also has a medical and social character, which is why worldwide attention is paid to the study of etiopathogenesis and treatment options for cataracts among people of working age. To date, cataract treatment involves only surgical removal of a clouded lens with implantation of an intraocular lens. More than 20 million such operations are carried out annually in the world. With the development of medical science and technological progress, new, more advanced surgical techniques are being developed, such as ultrasound and femtolaser phacoemulsification, which allow performing operations in the early stages of the disease and achieving better results in terms of visual acuity, avoiding the development of induced astigmatism, and reducing the likelihood of complications, including macular edema. However, despite the improvement of surgical techniques for cataract phacoemulsification, cases of postoperative complications are not uncommon. Thus, despite the study of the etiopathogenesis of cataracts and the development of advanced modern methods for its surgical treatment, the risk of complications remains. At the same time, the problem of preventing the development of macular postoperative edema is one of the main reasons for the decrease in visual acuity in operated patients. To reduce intraoperative complications, it is necessary to take into account risk factors, their combination, as well as improve the methods of their drug prophylaxis and treatment.

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Efficacy of LASIK and LASEK methods in achieving the predicted result in excimer laser correction of myopia and myopic astigmatism

Archive of Ukrainian Ophthalmology ◽

10.22141/2309-8147.8.3.2020.220450 ◽

2021 ◽

Vol 8 (3) ◽

pp. 19-23

Author(s):

N.G. Zavgorodnia ◽

Yu.Yu. Doroshenko ◽

T.S. Zavgorodnia ◽

I.O. Poplavska ◽

K.O. Kostrovska ◽

...

Keyword(s):

Visual Acuity ◽

Excimer Laser ◽

Anterior Segment ◽

Young Patients ◽

Surgical Techniques ◽

Social Significance ◽

Uncorrected Visual Acuity ◽

Working Age ◽

The Difference ◽

Myopic Astigmatism

Excimer laser correction of refraction anomalies has entered ophthalmological practice as one of the most effective surgical techniques, which allows us to correct refractive errors by changing corneal curvature, including with myopia and myopic astigmatism. Usually, such correction is applied in young patients of working age that acquires special social significance and requires the use of the most accurate and safe technologies, which would guarantee the achievement of a rapid effect with the shortest period of rehabilitation. The results of surgical treatment of 60 patients (103 eyes) with myopia of various degrees and myopic astigmatism were analyzed. Among patients, there were 28 men (41 %) and 32 women (59 %) aged 18 to 47 (mean of 25.0 ± 2.5) years. They were divided into 2 groups. The first group consisted of 29 people (50 eyes) who underwent vision correction by laser-assisted in situ keratomileusis (LASIK). All patients underwent standard ophthalmological examinations (visometry, autorefractometry, biomicroscopy, direct ophthalmoscopy, tonometry, perimetry) and refractive diagnosis, which included corneal topography with pachymetry (Orbscan, Bausch + Lomb Inc., USA), aberrometry (Zywave, Bausch + Lomb Inc., USA), anterior segment optical coherence tomography (Visante OCT, Carl Zeiss Meditec, Germany) and optical biometry by optical biometer IOLMaster (Carl Zeiss Meditec, Germany). The refractive result achievement was assessed on day 1, as well as 1 month, 6 months and 1 year after surgery. All surgeries were performed on an excimer laser Allegretto WaveLight EX500 (Alcon, USA). One month after excimer laser correction by the LASIK method, the expected result of visual acuity was achieved in 46 eyes (80.7 %), and when using the laser epithelial keratomileusis (LASEK) technique — in 31 eyes (58.5 %) that indicates a longer rehabilitation period. Six months later, the predicted visual acuity without correction in the group where surgery was performed by LASEK was achieved in 46 eyes (86.8 %), while in the group operated by LASIK — in 50 eyes, 100 % (the difference is not reliable, p > 0.05). One year after excimer laser correction, uncorrected visual acuity, regardless of the degree of myopia, was 0.92 ± 0.04 U in the first group at maximum visual acuity with correction in these eyes before surgery 0.86 ± 0.05 U (the difference is not significant, p > 0.05) and 0.74 ± 0.10 U in the second group at the maximum indicators of corrected visual acuity before surgery of 0.92 ± 0.03 U (the difference is significant, p < 0.05). A slightly larger difference in the achieved results of maximum uncorrected visual acuity before surgery when performing excimer laser correction by the LASEK method is explained by the development of subepithelial fibroplasia in 3.77 % of cases, which affected the average end result.

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Giant bladder calculus with no retention of urine

Bangladesh Journal of Medical Science ◽

10.3329/bjms.v14i1.21573 ◽

2015 ◽

Vol 14 (1) ◽

pp. 98-99

Author(s):

Imtiaz Shah ◽

Sarabjit Singh ◽

Nandita Mehta ◽

Tariq Ahmed Mala ◽

Mohammad Zaieem ◽

...

Keyword(s):

Treatment Options ◽

Medical Science ◽

Prostatic Hyperplasia ◽

Bladder Stone ◽

Medical Attention ◽

Surgical Removal ◽

Vesical Calculus ◽

Urinary Tract Symptoms ◽

Percutaneous Extraction ◽

Lower Urinary

Benign prostatic hyperplasia often produces chronic and progressive lower urinary tract symptoms or complications such as bladder stone, leading to retention of urine and to seek medical attention. Becharetal1 stated giant urinary bladder stone weighing 100 grams or more are uncommon. In our case 162 grams of bladder stone with few another stones about 10-15 grams in the left lower end of ureter were removed. Available treatment options for vesical calculus include open surgical removal, extracorporeal fragmentation and endoscopic crushing. Recently endo-surgical mechanical cystolithotripsy followed by percutaneous extraction has been in clinical practice for small and moderate sized calculus. DOI: http://dx.doi.org/10.3329/bjms.v14i1.21573 Bangladesh Journal of Medical Science Vol.14(1) 2015 p.98-99

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Intraoperative Anesthetic Management in an Asymptomatic and Biochemically Silent Pheochromocytoma

International Journal of Innovative Research in Medical Science ◽

10.23958/ijirms/vol06-i10/1227 ◽

2021 ◽

Vol 6 (10) ◽

pp. 716-719

Author(s):

Omar N. ◽

Shahid M. ◽

M. Bashir ◽

Imran S. ◽

Vipin K. ◽

...

Keyword(s):

Adrenal Mass ◽

Intraoperative Complications ◽

Anesthetic Management ◽

Preoperative Evaluation ◽

Hypertensive Crisis ◽

Surgical Techniques ◽

Surgical Removal ◽

Asymptomatic Patients ◽

Laparoscopic Techniques ◽

Chromaffin Tissue

Pheochromocytomas are tumors that originate from the chromaffin tissue of the adrenal medulla and commonly produce catecholamines. The diagnosis is typically established by the measurement of catecholamines or their metabolites in urine or plasma and tumors are localized with the use of radiographic and scintigraphic studies. Pheochromocytomas can occur in asymptomatic patients and the preferred treatment is surgical removal of the tumor. These chromaffin tissue tumors are not uncommon in anesthetic practice and have varied manifestations. The perioperative management of these tumors has improved remarkably over the yearsin conjunction with the evolution of surgical techniques (laparotomy to laparoscopic techniques and now to robotic approaches.). Majority of the patients present with normal clinical and biochemical parameters in the preoperative period, the incidence of hypertension being only 50 %. Even though patients may be clinically asymptomatic, surveillance and proper preoperative evaluation is important, as surgery for associated tumors may precipitate a hypertensive crisis and result in severe complications. We report an intraoperative anesthetic management of 32-year-old female with a left adrenal mass (pheochromocytoma) and left ovarian cyst. Throughout her entire course of treatment she was asymptomatic with normal blood pressure readings. Her biochemical screening was unremarkable. She underwent open surgical resection of the adrenal mass with confirmation of pheochromocytoma on histology. Pheochromocytoma represents very significant challenges to the anesthesiologist’s especially when undiagnosed. This case illustrates how paucity of literature on perioperative preparation of clinically and biochemically silent Pheochromocytomas led to serious intraoperative complications even in an asymptomatic, biochemically negative patient.

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CONTEMPORARY TREATMENT APPROACH OF SQUAMOUS CELL SKIN CANCER: REVIEW

Problems in oncology ◽

10.37469/0507-3758-2019-65-1-7-15 ◽

2019 ◽

Vol 65 (1) ◽

pp. 7-15

Author(s):

Aleksey Belyaev ◽

Georgiy Prokhorov ◽

Zamira Radzhabova ◽

Olga Baykalova

Keyword(s):

Skin Cancer ◽

Squamous Cell ◽

New Technologies ◽

Treatment Options ◽

Epidermoid Carcinoma ◽

Surgical Removal ◽

Cochrane Central Register ◽

Epithelial Tumor ◽

Randomized Controlled Studies ◽

Skin Malignancy

The incidence of skin cancer is a steady increasing around the world. Tumors of epithelial origin occupy the first place in the structure of all skin malignancy. Epidermoid carcinoma is the most malignant epithelial tumor of the skin and mucous membranes with squamous differentiation. Generally, squamous cell carcinoma is successfully treated by surgical and radiological methods. Often a different kind of plastic defect reconstructions are required after surgical removal. The incidence of epidermoid carcinoma increases with age (average age of patients falls on 65 years) therefore variants of treatment options is limited by comorbidities. However, surgical oncologist do not have enough date and randomized controlled studies on this theme. Minimally invasive methods, especially cryothechnology are increasingly used, but unfortunately their advantage requires additional evidence. We suppose Inclusion in the conventional treatment of new technologies may possibly improve the results of treatment. We reviewed the literature, summarizing data on various methods of treating squamous cell skin cancer. Comprehensive and systematic search was based on MedLine, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Scopus and PubMed among original articles for the period from January 1974 to October 2018.

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Excision of Lower Lip Mucocele Using Injection of Hydrocolloid Dental Impression Material in a Pediatric Patient: A Case Report

Applied Sciences ◽

10.3390/app11135819 ◽

2021 ◽

Vol 11 (13) ◽

pp. 5819

Author(s):

Gianluca Botticelli ◽

Marco Severino ◽

Gianmaria Fabrizio Ferrazzano ◽

Pedro Vittorini Velasquez ◽

Carlo Franceschini ◽

...

Keyword(s):

Minor Salivary Gland ◽

Surgical Techniques ◽

Surgical Excision ◽

Complete Healing ◽

Surgical Removal ◽

Clinical Approach ◽

Lower Lip ◽

Impression Material ◽

Dental Impression

Oral mucocele is a benign cystic exophytic lesion affecting the minor salivary gland and is especially present in pediatric patients (3% under 14 years). It is characterized by an extravasation or retention of fluid or mucus in the submucosal tissue of the minor salivary glands. Several surgical techniques have been proposed over the years, including the excision of the mucocele by using the injection of a hydrocolloid impression material in the light of the cyst to prevent the collapse of the cystic wall and solidify the lesion, resulting in a better cleavage plan. The combined clinical approach between the combination of Shira’s technique and the surgical excision of the cystic lesion results in a conservative surgical removal of the lesion. Here, we reported the removal of a labial mucocele in a 14-year-old male patient, using the injection of a hydrocolloid impression material. At a 12 months follow up, the patient showed complete healing of the surgical site, showing a pinkish lip lining mucosa without scarring or recurrence of the primary lesion. The combined therapeutic approach between Shira’s technique and surgical excision allows a safe and predictable excision of the labial mucocele, minimizing the risk of recurrence.

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Evaluation of surgical outcome of giant intracranial meningiomas

Egyptian Journal of Neurosurgery ◽

10.1186/s41984-020-00092-9 ◽

2020 ◽

Vol 35 (1) ◽

Author(s):

Ramy Teama ◽

Mohamed Adawy ◽

Mohamed Emara

Keyword(s):

Surgical Outcome ◽

Intraoperative Complications ◽

Intracranial Meningioma ◽

Surgical Removal ◽

Study Group ◽

Main Body ◽

Total Removal ◽

Large Size ◽

Intracranial Meningiomas

Abstract Background The surgery of giant intracranial meningiomas (GIM) is difficult due to its large size, prominent vascularity, including and limiting visualization of various neurovascular structures, and severe cerebral edema. In this study, we will evaluate the surgical outcome of giant meningiomas according to our experience at our hospital in management of giant intracranial meningioma. Main body A retrospective analysis of 48 patients with histologically proven meningioma (≥ 6-cm diameter) who underwent surgical treatment at Benha University hospitals over a period of 5 years (June 2014/June 2019) is presented. Details regarding clinical presentation, imaging findings, surgical results and complications, and follow-up status were collected. The study group was composed of 41 females and 7 males. The age of the study group ranged from 38 to 69 years with an average of 49 years. The mean follow-up period was 36 months. Different approaches were used according to tumor location with the aim of gross total removal. Gross total removal was achieved in 90% of cases (43 cases). There were 2 cases with intraoperative complications not related to surgery. Recurrence was present in 4 cases. Mortality in this series was 4% (2 cases) with no reported intraoperative mortality. Conclusion Management of giant intracranial meningioma is a relatively common practice in neurosurgical centers in developing countries with the aim of radical total surgical removal being the first and most optimum option. Large size makes surgery difficult, but young age, meticulous surgical techniques, proper localization, trying to minimize operative time, and Simpson grade are of special value. Interdisciplinary cooperation is essential to avoid the common complications like pulmonary embolism (PE), postoperative hematoma in tumor bed that leads to bad surgical outcome.

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Development of Stage 4 Macular Hole after Spontaneous Closure in a Patient with Stage 2 Macular Hole and a Lamellar Macular Hole-Associated Epiretinal Proliferation

Case Reports in Ophthalmology ◽

10.1159/000513132 ◽

2021 ◽

pp. 481-484

Author(s):

Masahisa Watanabe ◽

Harumasa Yokota ◽

Hiroshi Aso ◽

Hirotsugu Hanazaki ◽

Junya Hanaguri ◽

...

Keyword(s):

Visual Acuity ◽

Macular Hole ◽

Spontaneous Closure ◽

Surgical Removal ◽

Lamellar Macular Hole ◽

Full Thickness ◽

Stage 4 ◽

Full Thickness Macular Hole ◽

The Right ◽

Hole Closure

Herein, we report the longitudinal observation of a case with reopening of the macular hole associated with a lamellar macular hole-associated epiretinal proliferation (LHEP) followed by spontaneous closure in patients with stage 2 idiopathic macular hole. A 64-year-old woman was referred for the decreased visual acuity (VA) and acute anorthopia in the right eye. Funduscopy and optical coherence tomography (OCT) showed stage 2 full-thickness macular hole without posterior vitreous detachment (PVD) and operculum formation. Her best-corrected visual acuity (BCVA) was 20/32. One month later, the diameter of the macular hole was getting small and VA improved. Six months later, the macular hole was treated spontaneously with the attached hyaloid membrane to the macula by OCT and the BCVA improved to 20/20. Fourteen months after the first visit, the BCVA decreased to 20/50 and the patient was diagnosed with stage 4 macular hole with complete PVD. OCT showed full-thickness macular hole with a LHEP in the right eye. After 25G-gauge vitrectomy with the peeling of internal limiting membrane (ILM) and LHEP, the macular hole was closed and BCVA finally improved to 20/25. Spontaneous macular hole closure without PVD may rarely occur in patients with LHEP. The surgical removal of ILM and LHEP may contribute to the successful macular hole closure after vitrectomy.

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Photorefractive keratectomy for correction of myopia: Our one-year experience

Vojnosanitetski pregled ◽

10.2298/vsp1210852r ◽

2012 ◽

Vol 69 (10) ◽

pp. 852-857

Author(s):

Mirko Resan ◽

Miroslav Vukosavljevic ◽

Milorad Milivojevic

Keyword(s):

Visual Acuity ◽

Postoperative Complications ◽

Intraoperative Complications ◽

Mean Value ◽

Ablation Depth ◽

Laser In Situ Keratomileusis ◽

Photorefractive Keratectomy ◽

Corneal Tissue ◽

Surgical Method ◽

A Prospective Study

Background/Aim. Photorefractive keratectomy (PRK), after laser in situ keratomileusis (LASIK), is commonly performed refractive surgical method worldwide. The aim of this study was to examine the effectiveness and safety of PRK in correction of various strengths of myopia and to assess how much corneal tissue is being removed with one diopter sphere (Dsph) correction by using different optical zones (OZ). Methods. A prospective study with a follow-up period of 6 months included 55 patients of which 100 myopic eyes were treated by PRK method (one eye was included in 10 patients). Myopic eyes with a preoperative best corrected visual acuity (BCVA) = 1.0 (20/20) were analysed. In order to assess the effectiveness of PRK operated myopic eyes were divided into four groups according to the dioptric power: 1)? -1.75 Dsph (n = 26); 2) from -2 to -3.75 Dsph (n = 44); 3) from -4 to -6.75 Dsph (n = 23), and 4) ? -7 Dsph (n = 7). Myopic eyes with preoperative BCVA ? 0.9 (amblyopic eyes) were excluded from the study, as well as eyes with astigmatism > -1.5 Dcyl. To assess the effectiveness of PRK we examined the percentage of eyes in the mentioned groups, which derived uncorrected visual acuity (UCVA) 6 months after the intervention to the following: a) UCVA = 1.0 (20/20) and b) UCVA ? 0.5 (20/40). To assess the safety of PRK we examined the frequency of intraoperative and postoperative complications. To estimate how much corneal tissue was removed with one Dsph correction by using different OZ, we used preoperative and postoperative (after 6 months) central pachymetry values expressed in ?m and volume of cornea (central 7 mm) expressed in mm?. In that sense, we used only the myopic eyes with clear preoperative spherical refraction. The total number of these eyes was 27, of which 16 eyes were treated using a 6.5 mm OZ and 11 eyes using a 7 mm OZ. Results. Refractive spherical equivalent (RSE) for all eyes was in the range from -0.75 to -8.75 Dsph, and preoperative mean value of RSE with standard deviation (mean RSE ? SD) was -3.32 ? 1.83 Dsph. Six months after PRK, 91% of eyes had UCVA = 20/20, and 99% of eyes had UCVA ? 20/40. In the first group (? -1.75 Dsph) preoperative mean RSE ? SD was -1.34 ? 0.32 Dsph, six months after PRK, 96% of eyes had UCVA = 20/20, and 100% of eyes had UCVA ? 20/40. In the second group (from -2 to -3.75 Dsph) preoperative mean RSE ? SD was - 2.95 ? 0.57 Dsph, six months after PRK, 89% of eyes had UCVA = 20/20, and 100% of eyes had UCVA ? 20/40. In the third group (from -4 to -6.75 Dsph) preoperative mean RSE ? SD was - 4.93 ? 0.70 Dsph, six months after PRK, 100% of eyes had UCVA = 20/20. In the fourth group (? - 7 Dsph) preoperative mean RSE ? SD was -7.71 ? 0.67 Dsph, six months after PRK, 57% of eyes had UCVA = 20/20, and 86% of eyes had UCVA ? 20/40. There were no intraoperative complications while postoperative complications occurred in 2 patients - in both cases in one eye (2%). In that cases, epithelial defects were detected. In the group of eyes that were treated by 6.5 mm OZ mean RSE ? SD was -2.45 ? 0.99 Dsph, the ablation depth per 1 Dsph was 17.54 ? 5.58 ?m and ablated volume of central 7 mm cornea by 1 Dsph was 0.43 ? 0.18 mm?. In the group of eyes that were treated by 7 mm OZ mean RSE ? SD was -3.32 ? 2.26 Dsph, the ablation depth per 1 Dsph was 23.73 ? 6.91 ?m and ablated volume of central 7 mm cornea by 1 Dsph was 0.61 ? 0.31 mm?. Conclusion. PRK is effective and safe refractive surgical method for correcting myopia up to -8 .75 Dsph. OZ size is the main factor determining the depth of the excimer laser ablation of the corneal tissue volume consumed by 1 Dsph. Higher OZ value determines higher consumption of cornea tissue.

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Efficiency of Conditionally Attenuated Salmonella enterica Serovar Typhimurium in Bacterium-Mediated Tumor Therapy

mBio ◽

10.1128/mbio.00254-15 ◽

2015 ◽

Vol 6 (2) ◽

Cited By ~ 38

Author(s):

Michael Frahm ◽

Sebastian Felgner ◽

Dino Kocijancic ◽

Manfred Rohde ◽

Michael Hensel ◽

...

Keyword(s):

Salmonella Enterica ◽

Tumor Targeting ◽

Antitumor Effect ◽

Treatment Options ◽

Tumor Therapy ◽

Therapeutic Benefit ◽

Industrialized Countries ◽

Content Type ◽

Serovar Typhimurium ◽

Therapeutic Molecules

ABSTRACTIncreasing numbers of cancer cases generate a great urge for new treatment options. Applying bacteria likeSalmonella entericaserovar Typhimurium for cancer therapy represents an intensively explored option. These bacteria have been shown not only to colonize solid tumors but also to exhibit an intrinsic antitumor effect. In addition, they could serve as tumor-targeting vectors for therapeutic molecules. However, the pathogenicS. Typhimurium strains used for tumor therapy need to be attenuated for safe application. Here, lipopolysaccharide (LPS) deletion mutants (ΔrfaL, ΔrfaG, ΔrfaH, ΔrfaD, ΔrfaP, and ΔmsbBmutants) ofSalmonellawere investigated for efficiency in tumor therapy. Of such variants, the ΔrfaDand ΔrfaGdeep rough mutants exhibited the best tumor specificity and lowest pathogenicity. However, the intrinsic antitumor effect was found to be weak. To overcome this limitation, conditional attenuation was tested by complementing the mutants with an inducible arabinose promoter. The chromosomal integration of the respective LPS biosynthesis genes into thearaBADlocus exhibited the best balance of attenuation and therapeutic benefit. Thus, the present study establishes a basis for the development of an applicably cancer therapeutic bacterium.IMPORTANCECancer has become the second most frequent cause of death in industrialized countries. This and the drawbacks of routine therapies generate an urgent need for novel treatment options. Applying appropriately modifiedS. Typhimurium for therapy represents the major challenge of bacterium-mediated tumor therapy. In the present study, we demonstrated thatSalmonellabacteria conditionally modified in their LPS phenotype exhibit a safe tumor-targeting phenotype. Moreover, they could represent a suitable vehicle to shuttle therapeutic compounds directly into cancerous tissue without harming the host.

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Application of the Monte Carlo Method for the Assessment of Long-term Success in Keratoprosthesis Surgery

Journal of Theoretical Medicine ◽

10.1080/1027366021000041386 ◽

2002 ◽

Vol 4 (3) ◽

pp. 183-190 ◽

Cited By ~ 1

Author(s):

W. Hitzl ◽

G. Grabner

Keyword(s):

Monte Carlo ◽

Visual Acuity ◽

Survival Analysis ◽

Monte Carlo Method ◽

Surgical Techniques ◽

Distribution Functions ◽

Time Interval ◽

Specific Method ◽

The Monte Carlo Method

The comparison of different methods of keratoprosthesis (KP) regarding their long-term success, as far as visual acuity is concerned, is difficult: this is the case both as a standardized reporting method agreed upon by all research groups has not been reported and far less accepted, and as the quality of life for the patient not only depends on the level of visual acuity, but also quite significantly on the “survival time” of the implant. Therefore, an analysis of a single series of patients with Osteo–Odonto–Keratoprosthesis (OOKP) was performed. Statistical analysis methods used by others in similar groups of surgical procedures have included descriptive statistics, survival analysis and ANOVA. These methods comprised comparisons of empirical densities or distribution functions and empirical survival curves. It is the objective of this paper to provide an inductive statistical method to avoid the problems with descriptive techniques and survival analysis. This statistical model meets four important standards: (1) the efficiency of a surgical technique can be assessed within an arbitrary time interval by a new index (VAT-index), (2) possible autocorrelations of the data are taken into consideration and (3) the efficiency is not only stated by a point estimator, but also 95% point-wise confidence limits are computed based on the Monte Carlo method, and finally, (4) the efficiency of a specific method is illustrated by line and range plots for quick illustration and can also be used for the comparison of different other surgical techniques such as refractive techniques, glaucoma and retinal surgery.

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