The Main Patterns of Disorders of the Visual System in Patients with Retinal Detachment in Pediatric and Adult Practice in Terms of the Level of Antioxidant Protection

The study included patients with a verified diagnosis of “Traction retinal detachment” (RD) in pediatric (50 patients, mean age 13.8 ± 1.1 years, age range from 11 to 18 years) and adults (50 patients, mean age 54, 6 ± 2.2 years, age range 19 to 72 years). The control groups included 25 children (mean age 13.1 ± 1.2 years) and 25 adults (mean age 52.8 ± 1.6 years) patients without pathology of the organ of vision. A comprehensive examination of the functional state of the visual analyzer was performed, including the assessment of clinical (maximum corrected distance visual acuity, BCVA), subjective (Quality of Life, QOL), hemodynamic (pulsation index in the central retinal artery, PI), electrophysiological (threshold of electrical sensitivity of the retina (PESR); threshold of electrical lability of the retina; critical frequency of fusion and flashing (presentation of a red object); photostress test) and biochemical (antioxidant activity in the lacrimal fluid, AOA; superoxide dismutase indicator, PS in the lacrimal fluid) indicators of the visual system. The data obtained indicate some differences in the studied parameters in patients with OS in pediatric and adult practice. In particular, a higher level of BCVA in adults was found (by 18.8 %, p < 0.001). Along with this, it was determined that RD in children is accompanied by more pronounced disorders of hemodynamic and antioxidant parameters, which is associated with a more pronounced degree of proliferative vitreoretinopathy and preservation of antioxidant defense mechanisms. The results of stepwise discriminant analysis of the statistical characteristic F, which determines the weighting coefficient of the relationship in the regression equation of the basic AOA parameter with each indicator in the general array, determined the following most informative indicators (F > 3.0) of the visual system of patients with OS associated with antioxidant protection: in an adult practice — BCVA, QOL, PI, PESR, PS; in pediatric practice — BCVA, PI, PESR, PS. The obtained similar results of statistical analysis for children and adults are actualized by research in pediatric practice aimed at increasing the clinical effectiveness of vitrectomy for RD based on antioxidant protection methods tested in adult practice.

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Use of Age Cutoff Policies for Adolescents in Pediatric Practice: Report from the Upper Midwest Regional Physician Survey

PEDIATRICS ◽

10.1542/peds.72.3.420 ◽

1983 ◽

Vol 72 (3) ◽

pp. 420-427

Author(s):

Michael David Resnick

Keyword(s):

Task Force ◽

Adolescent Medicine ◽

Physician Survey ◽

Upper Midwest ◽

Pediatric Practice ◽

Task Force Report ◽

American Academy Of Pediatrics ◽

Pediatric Education ◽

Age Limits ◽

Age Range

Increased pediatric participation in the health and medical care of adolescents has been encouraged over the last several years, both through the redefinition of the age range of pediatric practice by the American Academy of Pediatrics, and by the 1978 Task Force Report on Pediatric Education. Whereas the Task Force Report enunciated a framework for pediatric leadership in adolescent medicine, little is known about the extent to which adolescents are actually included in pediatric practice. Based upon the findings of the 1980-1981 Upper Midwest Regional Physician Survey, the use of age "cutoff" policies for adolescents is explored. The various types of such policies are examined, in addition to reasons for their use and non-use, the characteristics of pediatricians who include and exclude adolescents from their practice, exceptions made to adolescent age limits, differential enforcement by patient and physician gender, and anticipated changes in cutoff policies in light of projected demographic changes for infants, children and youth, and physician supply.

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Audit of combination and high-dose antipsychotic treatment in the community

The Psychiatrist ◽

10.1192/pb.bp.112.039750 ◽

2013 ◽

Vol 37 (9) ◽

pp. 302-307 ◽

Cited By ~ 2

Author(s):

Lovely Rajan ◽

Ian Clarke

Keyword(s):

Clinical Effectiveness ◽

Information Management System ◽

Antipsychotic Treatment ◽

Clinical Implications ◽

High Dose ◽

Health Board ◽

Antipsychotic Therapy ◽

Health Records ◽

Icd 10 ◽

Age Range

Aims and methodTo estimate the community prevalence of combination antipsychotic therapy and high-dose antipsychotic treatment via audit. Patients with an ICD-10 diagnosis of schizophrenia were identified through the NHS Greater Glasgow and Clyde Health Board patient information management system and their mental health records examined.ResultsIn audit 1, 135 records were examined. The age range of patients was 24–74 years; 73% were male. Twelve per cent were on combined antipsychotic treatment and 3.7% required high-dose antipsychotics. Sixty-nine per cent of patients had documented in their record the reason for combined antipsychotic treatment compared with 40% on high-dose antipsychotics. In audit 2 (1 year later), 150 records were examined. Demographic details and prescription patterns remained similar to that of audit 1. However, 10% of patients received combined antipsychotic therapy and 2% remained on high-dose antipsychotics. Documented reasons for combination therapy increased to 87%, and to 67% for patients on high-dose antipsychotics.Clinical implicationsWe need robust clinical trials, overcoming the problems of clinical effectiveness and clinical efficiency, to establish the merits of preferred antipsychotic combinations, as combination and high-dose antipsychotic treatments are unlikely to be eliminated in clinical practice in the foreseeable future.

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Rhegmatogenous Retinal Detachment in Children

Russian ophthalmology of children ◽

10.25276/2307-6658-2020-4-29-35 ◽

2020 ◽

pp. 29-35

Author(s):

O.V. Diskalenko ◽

◽

O.A. Konikova ◽

V.V. Brzheskiy ◽

◽

...

Keyword(s):

Visual Acuity ◽

Surgical Treatment ◽

Retinal Detachment ◽

Treatment Efficacy ◽

Rhegmatogenous Retinal Detachment ◽

Clinical Course ◽

Vitreoretinal Surgery ◽

Scleral Buckling ◽

Stickler Syndrome ◽

Pediatric Practice

Purpose. To study the etiological structure of rhegmatogenous retinal detachment, the efficacy and outcomes of its surgical treatment in pediatric practice. Material and Methods. A retrospective series of cases in one vitreoretinal center in 2015–2019 was presented. The age of the children with rhegmatogenous retinal detachment (57 patients / 66 eyes) was from 0 to 18. Surgical treatment included vitreoretinal and scleral buckling techniques. Results. Rhegmatogenous retinal detachment in 30.3% of cases developed against the background of ROP, in 24.2% – against the background of Stickler‘s syndrome, in 12.1% – against the background of myopia, in 12.1% – against the background of trauma, and in 21.3 % – against the background of other reasons. On average, the anatomical treatment efficacy was 77.4%. The leading factors of an unfavorable outcome of treatment were the duration of presence of retinal detachment (OR 21.44; CI 3.76– 122.16) and 3–5 stages ROP (OR 2.56; CI 0.76–8.44). Visual acuity exceeding the blindness threshold (Vis > 0.02) was maintained or achieved in 72% of cases. Conclusions. The specificity of the clinical course and adherence to surgical treatment of children with rhegmatogenous retinal detachment is determined by its etiology. Key words: retinal detachment in children, Stickler syndrome, retinopathy of prematurity, scleral buckling, vitreoretinal surgery.

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The clinical effectiveness and safety of prophylactic retinal interventions to reduce the risk of retinal detachment and subsequent vision loss in adults and children with Stickler syndrome: a systematic review

Health Technology Assessment ◽

10.3310/hta15160 ◽

2011 ◽

Vol 15 (16) ◽

Cited By ~ 10

Author(s):

C Carroll ◽

D Papaioannou ◽

A Rees ◽

E Kaltenthaler

Keyword(s):

Systematic Review ◽

Retinal Detachment ◽

Vision Loss ◽

Clinical Effectiveness ◽

Stickler Syndrome ◽

Adults And Children

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Mukolitics in the therapy of respiratory diseases in pediatric practice

Medical Council ◽

10.21518/2079-701x-2020-10-48-54 ◽

2020 ◽

pp. 48-54

Author(s):

E. L. Rashitova ◽

A. M. Zakirova ◽

A. G. Kadriev ◽

A. A. Kadriev

Keyword(s):

Respiratory Diseases ◽

Clinical Symptoms ◽

Recovery Period ◽

Dynamic Control ◽

Clinical Effectiveness ◽

Main Group ◽

Pediatric Practice ◽

Treatment Standards ◽

Cough Syrup ◽

Wet Cough

Introduction. Mucolytic drugs are included in treatment standards and clinical guidelines for the management of children with respiratory diseases.Target. To study the effectiveness of mucoactive therapy through its comparative evaluation in pediatric practice with respiratory pathology.Materials and methods. A total of 48 patients (mean age 8.6 ± 4.1 years) with respiratory diseases were examined. They received conventional therapy and were divided into groups: the main one took Ambroxol (26) in syrup 15 mg/5 ml three times a day 4 days; comparison – a complex cough syrup with marshmallow (22) three times a day – 7 days. Dynamic control of clinical symptoms through statistical analysis and on special scales, accounting for clinical symptoms were evaluated out on the 1st, 3rd, 5th, 7th and 10th day from the start of mucoactive therapy.Results and discussion. The reception of ambroxol was accompanied by a pronounced muco-regulatory effect. On the 2nd day of treatment: significant relief of sputum discharge (p = 0.0002), dry cough stopped faster (p = 0.0007), wet cough remained in the recovery period for a short time (p = 0.003); by the 4th–6th day of treatment, a significant decrease in sputum volume and its production period (p = 0.017), shorter duration of dry (3.82 ± 0.84 and 1.79 ± 0.18 days; p = 0.022) and wet rales in the lungs (3.57 ± 0.78 and 1.61 ± 0.21 days; p = 0.024), the severity of dry cough in the main group by 5–7 days in children with allergopathology was less (p = 0.0001). On the 7th day, the severity of wet rales in patients of the main group was 0.08 ± 0.05 points, and in the comparison group 0.18 ± 0.07 points (p = 0.0003), the duration of wet cough (4.4 ± 0.23 against 5.71 ± 0.38 points), sputum discharge (4.63 ± 0.38 against 5.74 ± 0.35 points) and rhinorrhea (2.69 ± 0.57 against 4.42 ± 0.32 points) (p < 0.05).Findings. The clinical effectiveness of secretolitics is confirmed by reliably quick relief of dry and wet cough, sputum production intensity.

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Temporary percutaneous radiologic gastrojejunostomy with single gastropexy

Acta Radiologica ◽

10.1177/0284185120929707 ◽

2020 ◽

pp. 028418512092970

Author(s):

Jung-Hoon Park ◽

Young Chul Cho ◽

Ji Hoon Shin ◽

Yasir Nouri ◽

Jong Woo Kim ◽

...

Keyword(s):

Enteral Nutrition ◽

Esophageal Perforation ◽

Clinical Success ◽

Oral Intake ◽

Clinical Effectiveness ◽

Technical Feasibility ◽

Needle Technique ◽

The One ◽

Age Range

Background Although the effectiveness of percutaneous radiologic gastrojejunostomy (PRGJ) has been reported, a detailed description of the indications and clinical effectiveness of temporary PRGJ is still limited. Purpose To evaluate the clinical effectiveness and technical feasibility of temporary PRGJ using the modified Chiba-needle technique with single gastropexy. Material and Methods Temporary PRGJ using the modified Chiba-needle technique with single gastropexy was performed in 27 consecutive patients (19 men, 8 women; mean age = 61 years; age range = 32–77 years) for esophageal perforation (n = 18) or postoperative gastroparesis (n = 9). Outcomes analyzed included the technical and clinical success, procedure-related complications, and the tube indwelling period. Results Technical and clinical success was achieved in all 27 patients. All the tubes were electively removed 19–364 days (mean indwelling period = 104 days) after confirmation of the possibility of oral intake. Asymptomatic pneumoperitoneum occurred in 2/27 (7.4%) patients as minor complications and was resolved spontaneously by the time of the one-week follow-up. There were no major complications. During the follow-up period, a total of 11 tube changes were performed in seven patients for an elective tube change within a six-month interval (n = 5) or because of tube occlusion (n = 6). Conclusion Temporary PRGJ using the modified Chiba-needle technique with a single gastropexy was clinically effective and technically feasible in patients with esophageal perforation or gastroparesis. It can provide adequate enteral nutrition during its temporary placement.

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The Common Indications of Pars plana vitrectomy (PPV) for posterior Segment Ocular diseases in patients from a Private Retina Clinic

10.53350/pjmhs2115102759 ◽

2021 ◽

Vol 15 (10) ◽

pp. 2759-2762

Author(s):

Sidrah Riaz ◽

Umair Tariq Mirza ◽

Kashif Iqbal ◽

Muhammad Tariq Khan ◽

Khurram Azam Mirza ◽

...

Keyword(s):

Retinal Detachment ◽

Pars Plana Vitrectomy ◽

Survey Methods ◽

Vitreous Hemorrhage ◽

Posterior Segment ◽

Ocular Diseases ◽

Silicon Oil ◽

Pars Plana ◽

Age Range ◽

Anatomical Success

Purpose: To evaluate common indications and anatomical outcomes of PPV for posterior segment ocular diseases in patients presenting at private retina clinic in Lahore Study design: Cross sectional survey Methods and materials: Over the period of three years, from 1st April 2017 to 3oth April 2020, all patients fulfilling inclusion criterion, were included in study after approval from hospital ethical committee. After taking history and detailed ocular examination, diagnosis was confirmed by B scan or OCT, Hepatitis B & C screening done. The patient age, gender, laterality of eye, lens status, macular status, type of retinal pathology, type of anesthesia, procedure done and type of vitreous tamponade if used were noted. All procedures were performed by a single surgical team and patients were followed for six months for anatomical success or any complication. Data was analyzed by SPSS 25. Results: Out of 266 total patients, 168 (63.2%) were males and 98 (36.8%) were females. Right eye was involved in 125 (47%) and left in 141 (53%). Age range was from 2 years to 83years, mean age for males was 47.30, for females 48.07 years, median age was 50 years, mean age for GA was 30.62 years and 51.71 for LA patients. The highest incidences of posterior segment ocular problems were observed in patients with age range 51 to 60 years. The commonest indication for posterior segment surgery were RRD seen in 107 (40.23%), ROSO in 51 (19.17%) and vitreous hemorrhage 33 (12.41%). Endophthalmitis was indication in 20 (7.52%), dropped nucleus in 11 (4.13%), Macular hole in 7 (2.63%) and ERM in 3 (1.13%). Asteroid hyalosis, intraocular IOFB and diagnostic vitrectomy were least common indication, each seen in 1 (0.5%) patient. Silicon oil was most commonly used Endo tamponade used in 138 (51.88%) patients. All patients were followed for 6 months with vision and retinal status. All patients who underwent pars plana vitrectomy surgery were stable with anatomical success rate till 6 months postoperatively except 10 (3.76%) who required re do operation for retinal detachment or some other complications. Conclusion: Current practice in ophthalmology shows increased frequencies of internal approach (PPV) for vitreoretinal diseases rather external approach (SB). Silicon oil was most common internal tamponade used. Diabetic retinopathy was important cause of vitreous hemorrhage and TRD. Patients should be educated regarding regular fundoscopy and good systemic control of diabetes. Higher incidence of retinal detachment among all age groups needs awareness and education about its warning ocular symptoms. Key words: PPV (Pars plana vitrectomy), RRD (Rhegmatogenous retinal detachment), SB (Scleral buckling), TRD (Tractional retinal detachment), ROSO (removal of silicon oil), GA (general anesthesia), LA (local anesthesia)

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