scholarly journals Corneal crosslinking in septic melting corneal ulcers in dogs and cats

2019 ◽  
Vol 2019 (1) ◽  
pp. 11-17
Author(s):  
Сергей Бояринов ◽  
Serguey Boyarinov
Keyword(s):  
Inflammatory Process ◽  
Corneal Stroma ◽  
Underlying Disease ◽  
Complete Healing ◽  
Preliminary Treatment ◽  
Corneal Ulcers ◽  
Defect Zone ◽  
Corneal Vascularization ◽  
Number Of Patients ◽  
Surgical Methods

Objective of research. To evaluate the efficacy and safety of corneal collagen cross-linking during melting corneal ulcers in dogs and cats. Describe changes in the properties and structure of the cornea during the entire observation period. Materials and methods. 15 animals were included in the study: 8 dogs and 7 cats that received preliminary treatment for underlying disease, but without positive dynamics. All animals had an infectious-inflammatory process in the cornea with signs of keratomalacia. All animals underwent mechanical diepithelization of cornea with simultaneous surface surgical treatment of pathological tissues. CXL procedure was performed under general anesthesia with preliminary saturation of corneal stroma with riboflavin solution for 30 minutes. Results. All animals showed a decrease in purulent-inflammatory process 3...5 days after CXL. Keratomalacia inhibition was noted on average by 2 ... 3 days after procedure. By 7th day of observation, stabilization of wound process and epithelization of defect were observed in 11 animals. In 4 animals, this process lasted up to 10...12 days. In 13 animals, we observed active corneal vascularization by the 14th day after CXL. In 2 animals, regeneration process was avascular. By 30th day of observation, 13 animals showed complete healing of corneal defect zone with formation of fibrosis and slight vascularization, of which 4 dogs had partial deposition of pigment in defect zone. And 1 cat on 15th day had a perforation of cornea with iris prolapse and subsequent evisceration. Conclusion. This study shows that CXL is effective in animals with infectious keratitis, accompanied by keratomalacia. These results allow us to offer CXL as an alternative to surgical methods of treatment. This method is safe for structures of eye while observing recommended protocols, which was confirmed in our work. However, given small number of patients, further research is required to select optimal combination treatment regimen.

scholarly journals Experience of using a thrombofibrin clot of plateletrich plasma in ulcerative lesions of the cornea

2022 ◽  
Vol 14 (4) ◽  
pp. 15-21
Author(s):  
E. V. Fedoseeva ◽  
E. V. Chentsova ◽  
N. V. Borovkova ◽  
I. N. Ponomarev ◽  
V. A. Vlasova ◽  
...  
Keyword(s):  
Amniotic Membrane ◽  
Platelet Rich Plasma ◽  
Autologous Blood ◽  
Complete Healing ◽  
Autologous Serum ◽  
Amniotic Membrane Transplantation ◽  
Corneal Ulcers ◽  
Severe Burns ◽  
Surgical Methods ◽  
Extensive Damage

Purpose: to study the effectiveness of the use of thrombofibrin clot of platelet-rich plasma (PRP) in patients with corneal ulcers. Material and methods. A clinical study, conducted by the Department of Traumatology and Reconstructive Surgery of Helmholtz National Medical Research Center of Eye Diseases, involved 20 patients, aged from 22 to 82, with corneal ulcers of inflammatory and burn genesis more than 100 microns deep. All patients got coated with a thrombofibrin PRP clot from autologous blood. Prior to the study, all patients received standard treatment for 2 weeks to 3 months, including multiple amniotic membrane coating, with no effect. The thrombofibrin clot was produced by the Scientific Department of Biotechnology and Transfusiology of the N.V. Sklifosovsky Research Institute for Emergency Medicine. The ready clot was placed on the surface of the cornea and covered with an amniotic membrane. The membrane was fixed to the episclera along the border of the limb with a circular suture, whereupon autologous serum was injected along the limb in 4 quadrants, to be followed by temporary lateral blepharography. Results. On the 2nd day following the procedure, the patients noted a decrease in lacrimation and pain in the operated eye. As shown by optical coherence tomography, the average depth of the corneal ulcer at the beginning of the study in all patients was 129 ± 28.5 microns. On the 5th day, the depth lowered to an average of 71 ± 32.6 microns, and on the 10th day, to 23.3 ± 15.1 microns. In 7 patients (35%), complete healing of the defect was observed on the 15th day, while in 9 patients (45%) it was stated between the 16th and the 20th day. Thus, the average time of healing of the ulcer with complete epithelization occurred was 15 days. In four patients with the consequences of severe burns (20%), the ulcer did not heal due to extensive damage to the limbal zone. Conclusion. The use of a thrombofibrin PRP clot in combination with amniotic membrane transplantation allows achieving a stable and fairly rapid healing of corneal ulcers of various origins. However, this method is ineffective in patients with limbal cell insufficiency, severe burns and extensive damage to the limbal zone. In such cases, it is advisable to use more radical surgical methods, such as buccal or limbal cell transplantation, or allolimbal transplantation.

scholarly journals Epidemiology of Secondary Warm Autoimmune Haemolytic Anaemia—A Systematic Review and Meta-Analysis

2021 ◽  
Vol 10 (6) ◽  
pp. 1244
Author(s):  
Stinne Tranekær ◽  
Dennis Lund Hansen ◽  
Henrik Frederiksen
Keyword(s):  
Haemolytic Anaemia ◽  
Lupus Erythematosus ◽  
Meta Analysis ◽  
Underlying Disease ◽  
Age At Diagnosis ◽  
Autoimmune Haemolytic Anaemia ◽  
Sex Distribution ◽  
Number Of Patients ◽  
Study Results ◽  
Full Text Review

Background: Warm autoimmune haemolytic anaemia (wAIHA) is a haemolytic disorder, most commonly seen among adults and is classified as either primary or secondary to an underlying disease. We describe the age and sex distribution and the proportion of secondary wAIHA. Method: We retrieved 2635 published articles, screened abstracts and titles, and identified 27 articles eligible for full-text review. From these studies, we extracted data regarding number of patients, sex distribution, age at diagnosis, number of patients with secondary wAIHA, and whether the patients were diagnosed through local or referral centres. All data were weighted according to the number of included patients in each study. Results: 27 studies including a total of 4311 patients with wAIHA, of which 66% were females, were included. The median age at diagnosis was 68.7 years, however, wAIHA affected all ages. The mean proportion of secondary wAIHA was 49%, most frequently secondary to systemic lupus erythematosus. The proportions of secondary wAIHA reported from primary vs. referral centres were 35% vs. 59%, respectively. Conclusion: This review consolidates previously reported gender distribution. The higher proportion of secondary wAIHA in referral centres suggests that the most severely affected patients are disproportionally more frequent in such facilities.

Außerklinische Beatmung – Konzepte und Therapieempfehlungen

2017 ◽  
Vol 142 (16) ◽  
pp. 1197-1204 ◽  
Author(s):  
Sarah Schwarz ◽  
Friederike Magnet ◽  
Bernd Schönhofer ◽  
Wolfram Windisch
Keyword(s):  
Mechanical Ventilation ◽  
Scientific Evidence ◽  
Underlying Disease ◽  
Home Mechanical Ventilation ◽  
Term Survival ◽  
Number Of Patients ◽  
Related Quality ◽  
Außerklinische Beatmung ◽  
Health Related

AbstractThe prognosis of patients receiving home mechanical ventilation is very heterogeneous and depends on the underlying disease, the degree of respiratory dependency and the comorbidities. Due to the severe chronic diseases, the initiation of a long-term NIV must be done during an inpatient treatment. Two recently published randomized controlled trials using more aggressive forms of NPPV targeted at normalizing hypercapnic PaCO2 values, showed improved long term survival also in patients with an underlying diagnosis of COPD. Consequently, the number of patients receiving home mechanical ventilation has dramatically increased in recent years and more and more outpatient settings has been established without scientific evidence. Nevertheless, beside reliable care structures, ethical aspects and health related quality of life are of great importance in the context of home mechanical ventilation.

scholarly journals SOME ASPECTS OF CT ASSESSMENT OF SUPRAVESICAL URINARY TRACT IN PATIENTS AFTER CYSTILEOPLASTICS

2011 ◽  
Vol 2 (1) ◽  
pp. 54-56
Author(s):  
O P Sukhanova ◽  
T S Borondzhiyan ◽  
E V Minasyan
Keyword(s):  
Urinary Tract ◽  
Radical Cystectomy ◽  
Postoperative Period ◽  
Inflammatory Process ◽  
Underlying Disease ◽  
The State ◽  
Malignant Lesions ◽  
Degrees Of Severity ◽  
Late Postoperative Period ◽  
Ct Studies

The purpose of the research was to determine morphological and urodynamic changes of supravesical urinary tract in patients after cystileoplastics. Methods. CT studies in the late postoperative period in 19 patients after radical cystectomy, combined with vesiculoprostatectomy and cystoileoplastics and malignant lesions of the bladder were performed. Results. None of cases revealed signs of continued growth. In 57% of the cases it was evidence of lymphadenopathy in the absence of negative dynamics of the underlying disease. No dependence of the state of anastomoses of the volume formed by the reservoir and the degree of shortening of the ureter was found. In assessing the state of supravesical urinary tract 11 from 19 (57,8%) patients were registered varying degrees of severity gidroureteronephrosis, and in 4 patients, pelvic ureteric reflux. All patients with urodynamic disorders identified "new bladder" had less volume than patients who did not have these disorders. Conclusion. CT study is the method of choice in the evaluation of supravesical urinary tract after cystoileoplastics for timely prevention of complications of an inflammatory process. It was revealed that the degree of changes in the urinary tract depending of the volume of the reservoir formed, requires further analysis.

scholarly journals Vitrectomy for branch retinal vein occlusion with vitreous hemorrhage: proposal for a new grading system

2020 ◽  
Author(s):  
Gengmin Tong ◽  
Xuting Hu ◽  
Chenlei Zhu ◽  
Zhiqiang Gao ◽  
Xuhao Chen ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Retinal Vein Occlusion ◽  
Branch Retinal Vein Occlusion ◽  
Vitreous Hemorrhage ◽  
Grading System ◽  
Vein Occlusion ◽  
Number Of Patients ◽  
Surgical Methods ◽  
Significant Difference ◽  
Grade Iii

Abstract Purpose To investigate the long-term surgical outcomes after treatment with pars plana vitrectomy (PPV) combined with photocoagulation in different severities of branch retinal vein occlusion (BRVO) with vitreous hemorrhage (VH) in order to propose a new grading system. Methods We retrospectively reviewed the medical records of 117 eyes of 117 patients who underwent PPV for VH associated with BRVO and who were followed up for at least 12 months. Preoperative best-corrected visual acuity (BCVA), surgical intervention, final BCVA, and central foveal thickness (CFT) were evaluated using optical coherence tomography. We proposed a system to grade BRVO with VH from Grade I to Grade III with increasing severity: Grade I,pure persistent VH; Grade II,VH with epiretinal membrane (EM) (Grade IIa,VH with EM without macular involvement; Grade IIb,VH with EM with macular involvement); and Grade III,VH with tractive retinal detachment. Different surgical methods were appliedaccording to the different retinal conditions. Results BCVA significantly improved at final follow-up in all groups. There was no significant difference among the four groups in terms of preoperative BCVA, final BCVA,CFT,or the number of patients whose macular edema recurred after surgery (p>0.05), but there was a significant difference in vision improvement(p<0.05). Vision improvement in the Grade IIb group was significantly worse than in the Grade I group(p=0.006) and in the Grade IIa group(p=0.046). The percentage of patients in the Grade I, Grade IIa, Grade IIb, and Grade III groups needing further laser treatment after surgery was 0%, 8.3%, 16.3%, and 23.5%, respectively (p<0.05). Conclusion We proposed a new grading system for BRVO treated with PPV. Vitrectomy is a safe and effective treatment for BRVO with VH. Visual acuity improvement was significantly worse when the EM had macular involvement (Grade IIb).

Application of paste-type acellular dermal matrix in hard-to-heal wounds

2021 ◽  
Vol 30 (5) ◽  
pp. 414-418
Author(s):  
Sang Wha Kim ◽  
Hyung Sup Shim ◽  
Jihye Lee ◽  
Youn Hwan Kim
Keyword(s):  
Wound Healing ◽  
Adverse Events ◽  
Acellular Dermal Matrix ◽  
Complete Healing ◽  
Dermal Matrix ◽  
Wound Area ◽  
Number Of Patients ◽  
Complete Wound Healing ◽  
Zero Baseline ◽  
Acellular Dermal

Objective: The extracellular matrix (ECM) is one of the most important elements in wound healing. Absence or dysfunction of the ECM may impair wound healing. The application of acellular dermal matrix (ADM) as a substitute for ECM has been suggested. This study investigated the clinical application and wound healing effects of a paste-type ADM in patients presenting with hard-to-heal wounds due to various causes. Method: Patients with a hard-to-heal wound for >1 month, from September 2017 to February 2019, were included in this study. After debridement, the paste-type ADM was applied, at zero (baseline), two and four weeks. After application of the paste-type ADM, a conventional dressing was applied using polyurethane foam. Wound size, the formation of granulation tissue, re-epithelialisation, complete healing and adverse events were recorded at zero (baseline), one, two, four, eight and 12 weeks after the initial treatment. Results: A total of 18 patients took part (eight male, 10 female, mean age of 56±16.16 years). The mean wound area decreased from 17.42±10.04cm2 to 12.73±7.60cm2 by week one (p<0.05), to 10.16±7.00 by week two (p<0.0005), to 5.56±5.25 by week four (p<0.0001), to 2.77±5.15 by week eight (p<0.0001) and to 2.07±4.78 by week 12 (p<0.0001). The number of patients with >75% re-epithelialisation increased from two (11.1%) at two weeks to five (27.8%) at four weeks, to 11 (61.1%) at eight weeks and to 13 (72.2%) at 12 weeks. The number of patients showing complete wound healing was two (11.1%) at four weeks, nine (50.0%) at eight weeks and 12 (66.7%) at 12 weeks. No adverse events were reported during treatment. Conclusion: The paste-type ADM used in this study is a viable option for facilitating wound healing; it can shorten hospitalisation, and promote a faster recovery and return to normal life activities.

Prevalence of psychiatric disorders among patients with Multiple Sclerosis: a cross-sectional study.

2020 ◽  
Author(s):  
Michał Błachut ◽  
Anna Rebeka Szczegielniak ◽  
Krzysztof Świerzy ◽  
Magdalena Zając- Tarska ◽  
Katarzyna Kubicka-Bączyk ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Mental Disorders ◽  
Anxiety Disorders ◽  
Psychiatric Disorders ◽  
Underlying Disease ◽  
Psychiatric Evaluation ◽  
Cross Sectional ◽  
Mini International Neuropsychiatric Interview ◽  
Sociodemographic Data ◽  
Number Of Patients

Abstract Background: Multiple Sclerosis is one of the leading autoimmune disorders causing disability among young adults. Various types of mood, affect, and behaviour disorders along with cognitive impairment can be manifested in a course of MS, with affective and anxiety disorders being the most prevalent. Mental health challenges, in addition to the neurological burden of MS, significantly affect quality of life and the course of the underlying disease. Objective: The aim of this work was to determine the prevalence of mental disorders in a sample of MS patients during outpatient treatment in Zabrze, Poland, with a focus on those with mood and anxiety disorders, and to compare the results obtained in these groups with clinical and sociodemographic data. Method: The study was conducted between 2017 and 2018 on 103 MS patients of the Neurological Outpatient Clinic of the Medical University of Silesia Hospital No.1 in Zabrze, Poland. During the study, sociodemographic data were collected, as well as the type and course of the underlying disease, comorbidities, and medicines used. The MINI-international neuropsychiatric interview and a psychiatric examination were utilized to assess the occurrence of mental disorders. Result: 68% of all patients received a psychiatric diagnosis at some point in their life with only 4% having been hospitalized before; 49.5% met the diagnostic criteria for various psychiatric disorders. Measured by the MINI International Neuropsychiatric Interview, 33% of patients reported a past episode of major depression while 8.7% met the criteria for a current episode. The same number of patients admitted ongoing treatment due to recurrent depressive disorder. In regards to anxiety disorders, the most common was generalized anxiety disorder (10.7%), followed by agoraphobia (8.7%), panic disorder (7.8%), and social phobia (4.9%). Most of the patients (94.2%) at the time of the psychiatric evaluation presented a low level of suicide risk, while 1.9% of the patients presented a medium risk, and 3.9% - a high risk. Conclusion(s): The study confirmed a significantly higher prevalence of mental disorders among MS patients; thus, the psychiatric state of patients in this group should be investigated systematically, simultaneously with the assessment of their neurological state. Trial registration: N/A Key words: Multiple Sclerosis, psychiatric disorders, comorbidity, psychiatric care, clinical characteristics.

Special considerations in the immunosuppressed patient

2021 ◽  
pp. 979-989
Author(s):  
Anne-Sophie Moreau ◽  
Raphaël Favory
Keyword(s):  
Intensive Care ◽  
Heart Transplantation ◽  
Underlying Disease ◽  
Rapid Diagnosis ◽  
Hiv Treatment ◽  
Cardiac Complications ◽  
Immunosuppressed Patient ◽  
Haematological Malignancies ◽  
Secondary Neoplasms ◽  
Number Of Patients

Because of improved treatment of haematological malignancies, autoimmune diseases, and HIV infection, an increasing number of patients are being immunocompromised. Immunosuppression varies according to the underlying disease, and different patterns of complications may be encountered. Among the complications of immunosuppressive treatments, infectious diseases are the most frequently encountered, but drug-related toxicities and secondary neoplasms have to be recognized. Making a rapid diagnosis is the most important step in taking these patients in charge. In such setting, cardiac involvement is severe and often leads to admission to intensive care units. This chapter will focus on the cardiac complications of immunosuppression, from heart transplantation to HIV treatment-related toxicity and cardiac infections.

Suppurative Thrombophlebitis: Correlation Between Pathogen and Underlying Disease

1986 ◽  
Vol 7 (12) ◽  
pp. 582-585 ◽  
Author(s):  
Capt Robert A. Johnson ◽  
Capt Robert A. Zajac ◽  
Maj Martin E. Evans
Keyword(s):  
Staphylococcus Aureus ◽  
Pseudomonas Aeruginosa ◽  
Nosocomial Infection ◽  
Abdominal Surgery ◽  
General Hospital ◽  
Inflammatory Process ◽  
Surgical Intervention ◽  
Underlying Disease ◽  
Streptococcus Faecalis ◽  
Apparent Association

AbstractWe identified 29 episodes of suppurative thrombophlebitis in 27 patients admitted to a large general hospital between May 1980 and May 1984. In 25 patients, the intravenous cannulae had been in place for more than 3 days. Streptococcus faecalis, Pseudomonas aeruginosa or one of the Enterobacteriaceae were implicated in 14 patients. All these patients had recently undergone abdominal surgery or had a major intraabdominal inflammatory process at the time they developed thrombophlebitis. The remaining 13 patients were infected with Staphylococcus aureus, other grampositive cocci or Candida species. Only two of these had an active abdominal process at the time of their infection (x2 = 16.08, P<0.001). There is an apparent association between phlebitis caused by enteric organisms and active intra-abdominal pathology. There were two deaths related to delayed or deferred surgery. Suppurative thrombophlebitis is a lethal, preventable nosocomial infection that requires urgent surgical intervention.

Application of a collagen matrix dressing on a neuropathic diabetic foot ulcer: a randomised control trial

2020 ◽  
Vol 29 (Sup3) ◽  
pp. S13-S18 ◽  
Author(s):  
Gholamreza Esmaeeli Djavid ◽  
Seyed Mehdi Tabaie ◽  
Siamak Bashardoust Tajali ◽  
Mehrangiz Totounchi ◽  
Amirreza Farhoud ◽  
...  
Keyword(s):  
Diabetic Foot ◽  
Wound Care ◽  
Healing Process ◽  
Collagen Matrix ◽  
Complete Healing ◽  
Randomised Control Trial ◽  
Control Group ◽  
Study Group ◽  
Number Of Patients

Objective: Diabetic foot ulcers (DFU) are often hard-to-heal, despite standard care. With such a complicated healing process, any advanced wound care to aid healing is recommended. Chitosan/collagen composite hydrogel materials have the potential to promote the regenerative process. In this study, the efficacy of a new collagen matrix dressing including chitosan/collagen hydrogel was compared with a standard dressing of saline-moistened gauze for wound healing in patients with a hard-to-heal neuropathic DFU. Method: This is an open labelled, randomised clinical trial. After conventional therapy consisting of debridement, infection control and offloading, patients were randomly allocated to receive either a collagen matrix dressing (the study group, receiving Tebaderm manufacturer) or a saline-moistened gauze dressing (control group) for wound care. The reduction in DFU size and the number of patients with complete healing were measured throughout the treatment and in follow-up. Results: A total of 61 patients with a neuropathic DFU were recruited. Average percentage reduction in DFU size at four weeks was greater in the study group compared with the control group (54.5% versus 38.8%, respectively). Rate of complete healing rate at 20-weeks' follow-up was significantly better in the study group than the control group (60% versus 35.5%, respectively). Conclusion: The collagen matrix dressing used in this study accelerated the healing process of patients with a hard-to-heal DFU. Further research may suggest the used of this dressing to shorten the length of time to achieve complete healing.

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