scholarly journals Bilateral phacoemulsification of cataract: the opinion of foreign ophthalmologists

2022 ◽  
Vol 14 (4) ◽  
pp. 154-157
Author(s):  
I. B. Medvedev ◽  
D. F. Pokrovsky
Keyword(s):  
High Risk ◽  
General Anesthesia ◽  
Intraocular Lens ◽  
Vision Loss ◽  
Surgical Intervention ◽  
Sustainable Culture ◽  
Expert Assessments ◽  
Main Factors ◽  
Major Factors ◽  
Negative Factors

Рurpose: to present the opinion of foreign ophthalmic surgeons on simultaneous bilateral phacoemulsification of cataract (SBPEC) by analyzing literature data. We performed an analysis of papers listed by Pubmed in 2000–2020 which contained expert assessments of SBPEC effectiveness based on polling. Ophthalmic surgeons were offered special questionnaires largely close in content, which were designed to establish the rating of factors that affected the respondents’ decision for or against the surgery. Our results indicate that, depending on the country, from 13.9 to 86 % of ophthalmic surgeons practice SBPEC, while from 14.0 to 67.2 % refrain from using this technology. The surveys revealed three major factors in favor of SBPEC — reduced number of clinical visits, the patient’s convenience during rehabilitation, and a high risk of complications after a second general anesthesia. The main factors against SBPEC are the risk of endophthalmitis (noted by 69–73 % of respondents), the absence of information on the postoperative refractive result in the first eye, which could determine the choice of the intraocular lens on the second eye (74–80 %), the risk of bilateral vision loss (73–79 %), as well as possible forensic problems (52–58 %).Conclusion. The surveying highlights certain negative factors that need to be overcome in order for SBPEC to become more widespread. Raising the awareness of SBPEC practice and approval by the ophthalmic community is essential for a sustainable culture change regarding this technology. To achieve this aim, standardization of the SBPEC procedure is needed, followed by the development of training manuals and protocols for surgical intervention.

Late Presentation of Penetrating Ulcers at the Ascending Aorta Associated With Intra-Mural Haematoma

2020 ◽  
Vol 3 (2) ◽  
pp. 01-05
Author(s):  
Ayman Kenawy
Keyword(s):  
High Risk ◽  
Disease Progression ◽  
Surgical Repair ◽  
Surgical Intervention ◽  
Late Presentation ◽  
Ascending Aorta ◽  
Chronic Type ◽  
Penetrating Aortic Ulcer ◽  
Good Outcome ◽  
Pseudo Aneurysm

The combined pathology of intra-mural haematoma (IMH) and penetrating aortic ulcer (PAU) represents disease progression of the PAU with high risk for further progression to either rupture or pseudo-aneurysm formation, and hence surgical intervention should be offered once diagnosis is made regardless of the presentation. We present a 70-year-old fit lady with chronic type A IMH associated with multiple PAUs, diagnosed incidentally, the patient underwent urgent surgical repair with good outcome.

scholarly journals Recurrent Intraocular Lens Dislocation in a Patient with Familial Ectopia Lentis

2021 ◽  
Vol 18 (9) ◽  
pp. 4545
Author(s):  
Tomasz K. Wilczyński ◽  
Alfred Niewiem ◽  
Rafał Leszczyński ◽  
Katarzyna Michalska-Małecka
Keyword(s):  
Intraocular Lens ◽  
Pars Plana Vitrectomy ◽  
Vision Loss ◽  
Silicone Oil ◽  
Single Case ◽  
Recurrent Dislocation ◽  
Ectopia Lentis ◽  
Pars Plana ◽  
The Right

A 36-year-old patient presented to the hospital with recurrent dislocation of the intraocular lens (IOL). The patient with the diagnosis of familial ectopia lentis was first operated on for crystalline lens subluxation in the left eye in 2007 and in the right eye in 2009. In both eyes, lens extraction with anterior vitrectomy and transscleral fixation of a rigid IOL was performed. In 2011, the IOL in the right eye luxated into the vitreous cavity due to ocular trauma. The patient underwent a pars plana vitrectomy with the IOL resuturation to the sclera. Seven years later, a spontaneous vision loss in the right eye was caused by a retinal detachment. The pars plana vitrectomy with silicone oil tamponade and a consequential oil removal three months later were performed in 2018. The follow-up examination revealed recurrent IOL dislocation in the same eye. Due to a history of previous suture-related complications a decision was made to remove the subluxated rigid polymethyl-methacrylate (PMMA) IOL and fixate to sclera a sutureless SOLEKO FIL SSF Carlevale lens. The purpose of this report is to present a single case of a 36-year-old patient who was presented to the hospital with recurrent dislocation of the intraocular lens. In a three-month follow-up period, a good anatomical and functional outcome was finally obtained with transscleral sutureless intraocular lens. This lens is an option worth considering especially in a young patient with a long life expectancy and physically active.

scholarly journals 828 Is Isolation Before Elective Surgery the Way Forward During The COVID-19 Pandemic?

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
S James ◽  
G Lafaurie ◽  
R Hafeez
Keyword(s):  
High Risk ◽  
General Surgery ◽  
Elective Surgery ◽  
Patient’S Satisfaction ◽  
Anonymous Questionnaire ◽  
Nice Guidance ◽  
Main Factors ◽  
Mode Of Transport ◽  
Isolation Period ◽  
The Way

Abstract Introduction The COVID-19 pandemic is here to last, and services must adapt to enable elective surgery to continue. Surgery involves high-risk aerosol generating procedures, potentially harmful to staff and patients. The current NICE guidance is for the patient to self-isolate for 72 hours prior to surgery. A question persists: Is 72-hour isolation the way forward in elective general surgery? Method In a DGH centre, using an anonymous questionnaire, we prospectively collected data on isolation for 36 elective general surgery patients during the 72h isolation period. The data was analysed to assess the concordance with isolation as well as patient's satisfaction with the process. Results 75% of patients were concordant with 72 hours of isolation pre-operatively. This was an increase from 35% when compared to patients questioned during the 14 day isolation period. The main factors contributing to isolation breech were visitors to the house and the mode of transport used to attend hospital. Conclusions The protocol is now for a COVID swab 72 hours pre-operatively followed by isolation until the operation. Our results show that still significant breaches in isolation remain and patients welfare is adversely affected during that period. Further research and consideration is needed to optimise the COVID isolation protocol.

scholarly journals Artificial Intelligence: The Attitude of the Public and Representatives of Various Industries

2021 ◽  
Vol 14 (8) ◽  
pp. 339
Author(s):  
Tatjana Vasiljeva ◽  
Ilmars Kreituss ◽  
Ilze Lulle
Keyword(s):  
Artificial Intelligence ◽  
Primary Data ◽  
Structured Interviews ◽  
The Public ◽  
Qualitative And Quantitative ◽  
Public Survey ◽  
Significant Difference ◽  
Main Factors ◽  
Negative Factors ◽  
Near Future

This paper looks at public and business attitudes towards artificial intelligence, examining the main factors that influence them. The conceptual model is based on the technology–organization–environment (TOE) framework and was tested through analysis of qualitative and quantitative data. Primary data were collected by a public survey with a questionnaire specially developed for the study and by semi-structured interviews with experts in the artificial intelligence field and management representatives from various companies. This study aims to evaluate the current attitudes of the public and employees of various industries towards AI and investigate the factors that affect them. It was discovered that attitude towards AI differs significantly among industries. There is a significant difference in attitude towards AI between employees at organizations with already implemented AI solutions and employees at organizations with no intention to implement them in the near future. The three main factors which have an impact on AI adoption in an organization are top management’s attitude, competition and regulations. After determining the main factors that influence the attitudes of society and companies towards artificial intelligence, recommendations are provided for reducing various negative factors. The authors develop a proposition that justifies the activities needed for successful adoption of innovative technologies.

scholarly journals Formulating an anesthetic plan using a list of high-risk pregnant women on cloud-based business communication tools: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Junnosuke Kimura ◽  
Kento Kawamura ◽  
Manami Minoura ◽  
Ayako Hiramoto ◽  
Yoshifumi Suga ◽  
...  
Keyword(s):  
Case Report ◽  
High Risk ◽  
Cesarean Section ◽  
General Anesthesia ◽  
Pregnant Women ◽  
Cesarean Delivery ◽  
Business Communication ◽  
Communication Tools ◽  
Case Presentation ◽  
Emergency Cesarean

Abstract Background We report a case in which a list of high-risk pregnant women on cloud-based business communication tools was useful in formulating an anesthetic plan for unscheduled cesarean section. Case presentation A 37-year-old woman, who had been prescribed icosapentate for hypertriglyceridemia, received an antenatal anesthetic evaluation for possible cesarean delivery, and it was agreed that the anesthetic method for emergency cesarean section was general anesthesia if the surgery would take place within 7 days after the discontinuation of the drug, and regional anesthesia if it would take place any time later. Then this agreement was uploaded on the cloud-based business communication tools, and updated until she delivered her baby via unscheduled cesarean section. Conclusions A cloud-based business communication tools was useful in formulating an anesthesia plan for a patient undergoing a cesarean delivery. However, more discussion would be needed to utilize it in security.

Pigmentary Glaucoma After Cataract Surgery with Single-Piece Hydrophobic Intraocular Lens Implanted into the Ciliary Sulcus: Case Report

2021 ◽  
Vol 5 (1) ◽  
Keyword(s):  
Intraocular Pressure ◽  
Intraocular Lens ◽  
Corneal Endothelium ◽  
Surgical Intervention ◽  
Posterior Segment ◽  
The Other ◽  
Pigmentary Glaucoma ◽  
Single Piece ◽  
History Of ◽  
Capsular Bag

A 59 years old man presented with a history of phacoemulsification with an hydrophobic intraocular lens implant in his left eye 4 years ago. The biomicroscopy revealed pigments in the corneal endothelium (Krukenberg’s spindle), peripheral transillumination of the iris and intraocular pressure of 52 mmHg in the left eye. Gonioscopy revealed hyperpigmentation of the posterior trabeculate. Posterior segment examination and visual field revealed a cup/disc 0.9 with significant field damage in strategy 10-2. Biomicroscopic ultrasonography showed asymmetric implantation of the IOL loops in the left eye (one loop in the ciliary sulcus and the other in the capsular bag). He underwent antiglaucomatous treatment with adequate control of intraocular pressure, with no need for surgical intervention.

scholarly journals Legal Aspects in Obstetric Anesthesia

2016 ◽  
Vol 10 (2) ◽  
pp. 3-9
Author(s):  
S Chattopadhyay ◽  
A Rudra ◽  
M Ray ◽  
S Sengupta ◽  
S Goswami
Keyword(s):  
High Risk ◽  
General Anesthesia ◽  
Obstetric Anesthesia ◽  
Legal Aspects ◽  
Routine Practice ◽  
Good Doctor ◽  
Surgical Safety ◽  
Valid Consent ◽  
Headache Pain ◽  
Time Of Admission

Obstetric anesthesia is a particularly high-risk sub-specialty of anesthesia and may lead to serious morbidities and even mortality. Good doctor-patient relation from the time of admission till discharge is the most important factor to avert future litigations. Any procedure done or planned should be clearly documented. Documentation should start with a valid consent in the patient’s own language, and have all three components of voluntariness, capacity and knowledge. A ‘Surgical Safety’ checklist is particularly helpful in documentation and decreasing errors. Safety of the mother (and her child) is paramount. Both regional as well as general anesthesia, either inadvertently or if not administered properly may be associated with morbidities like headache, pain and emotional distress. However, deaths do occur and general anesthesia is associated with care should be routine practice and inculcated by everyone involved in patient care.

scholarly journals Submental method for orotracheal intubation in treating facial trauma

1998 ◽  
Vol 116 (5) ◽  
pp. 1829-1832 ◽  
Author(s):  
Luiz Carlos Manganello-Souza ◽  
Nicolas Tenorio-Cabezas ◽  
Luiz Piccinini Filho
Keyword(s):  
Tracheal Intubation ◽  
General Anesthesia ◽  
Surgical Intervention ◽  
Orotracheal Intubation ◽  
Facial Trauma ◽  
Facial Fractures ◽  
Surgical Team ◽  
Visible Scar ◽  
Alternative Method

OBJECTIVE: To demonstrate an alternative method for intubating patients with fractures of maxilla and nose, prior to surgery. DESIGN: Cases Report. PARTICIPANTS: We studied 10 patients with facial fractures that affected maxilla and nose. INTERVENTION: The patients were submitted to surgery under general anesthesia and submental oro-tracheal intubation. RESULTS: This type of intubation allowed the surgical team to work on the whole face of the patient and left no visible scar. CONCLUSION: This procedure is indicated for patients with fractures of maxilla and nose who need surgical intervention under general anesthesia.

Surgical Off-loading of the Diabetic Foot

2010 ◽  
Vol 100 (5) ◽  
pp. 369-384 ◽  
Author(s):  
Robert G. Frykberg ◽  
Nicholas J. Bevilacqua ◽  
Geoffrey Habershaw
Keyword(s):  
Diabetes Mellitus ◽  
High Risk ◽  
Diabetic Foot ◽  
Surgical Intervention ◽  
Surgical Decompression ◽  
Foot Ulcers ◽  
Foot Surgery ◽  
Patients With Diabetes

Surgical intervention for chronic deformities and ulcerations has become an important component in the management of patients with diabetes mellitus. Such patients are no longer relegated to wearing cumbersome braces or footwear for deformities that might otherwise be easily corrected. Although surgical intervention in these often high-risk individuals is not without risk, the outcomes are fairly predictable when patients are properly selected and evaluated. In this brief review, we discuss the rationale and indications for diabetic foot surgery, focusing on the surgical decompression of deformities that frequently lead to foot ulcers. (J Am Podiatr Med Assoc 100(5): 369–384, 2010)

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