FEATURES OF OPHTHALMIC CARE FOR PATIENTS WITH COMPLICATED CATARACTS

2020 ◽  
pp. 84-89
Author(s):  
Inna Ivanovna Lapkina
Keyword(s):  
Health Care ◽  
Surgical Treatment ◽  
Postoperative Complications ◽  
Key Words ◽  
Outpatient Treatment ◽  
Practical Application ◽  
Unified Approach ◽  
Case Histories ◽  
High Prevalence

Today, around 50 million people worldwide suffer from cataracts, more than a half of them need surgical treatment. High prevalence of this pathology in Ukraine, the need to improve the provision of ophthalmic care to patients, and the reform of the health care system have made the research relevant. Concomitant diseases and special conditions of the eye increase the risk of intra− and postoperative complications, worsen the functional parameters of patients after surgery. In order to develop a unified approach to the treatment of complicated cataracts based on diagnostically related groups of patients, a retrospective analysis of case histories of patients with different variants of complications related to the condition of the lens itself, its ligament apparatus and other structures of the eye was conducted. In each case, the surgeon has to choose the appropriate modification of cataract phacoemulsification surgery. The study proposed the classification of cataract phacoemulsification modifications on the basis of the techniques and the sequence of operation stages, taking into account the classification of the degrees of turbidity of the lens, proposed by L. Buratto. It has been noted that in complicated cases, according to the indications of the patient, surgery may be performed on several modifications of cataract phacoemulsification. The developed classification made it possible to generalize the various variants of pathology and greatly facilitate the choice of tactics of surgical treatment in complicated cataracts. It can be used not only for practical application, but also for improving the qualification of trained professionals. The prospect of further research is to identify contraindications for outpatient treatment of the patients with complicated cataracts. Key words: cataract complication, classification of phacoemulsification modifications, diagnostically related groups.

scholarly journals Pharmaceutical Cleanroom Classification using ISO 14644-1 and the EU GGMP Annex 1 Part 2: Practical Application

2020 ◽  
Author(s):  
Tim Eaton
Keyword(s):  
Key Words ◽  
Test Method ◽  
Practical Application ◽  
Medicinal Products ◽  
The Eu ◽  
Classification Test

Classification of cleanrooms and clean zones associated with the manufacture of medicinal products has been assessed in two articles. The first article discussed the classification requirements and principles associated with ISO 14644-1 and Annex 1 of the EU GGMP, and a suitable classification test method for aseptic manufacturing was derived. This second article considers the practical application of the method for the classification of a pharmaceutical cleanroom, and isolator located within it. Key words: Cleanroom classification, ISO 14644-1, EU GGMP Annex 1

Assessment of postoperative complications of transurethral contact pyelocalycоlithotripsy in patients with high-density stones according to the Clavien – Dindo classification

2020 ◽  
Vol 10 (4) ◽  
pp. 309-316
Author(s):  
Toirkhon Kh. Nazarov ◽  
Anisjon I. Tursunov ◽  
Ivan V. Rychkov ◽  
Magomed A. Ahmedov ◽  
Kseniya E. Trubnikova ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Postoperative Complications ◽  
Retrospective Analysis ◽  
Kidney Stones ◽  
Postoperative Period ◽  
Topical Issue ◽  
Unified Algorithm ◽  
Cavity System ◽  
Treatment Of Urolithiasis

Improving the effectiveness of treatment of urolithiasis is a topical issue in modern urology. Despite a large number of studies on this problem, there is currently no unified algorithm for assessing postoperative complications of removal of calculi of the renal cavity system by transurethral access. Purpose of the study: based on a retrospective analysis to adapt the classification of postoperative complications according to Clavien Dind from 2004 to describe the complications of transurethral contact pyelocalicolithotripsy. Materials and methods. A retrospective analysis of the results of surgical treatment of 211 patients with kidney stones with a density of 960 HU to 1840 HU was performed. Ultrasonic energy was used for lithotripsy. Criteria for the normal course of the postoperative period in patients have been formulated. Results. The number of postoperative complications was calculated. The obtained data are distributed according to the corresponding gradations of the adapted Clavien Dindо classification. Conclusion. The improved Clavien Dindo classification, taking into account the adaptation, can be used as an up-to-date, accessible and logical template for assessing the postoperative complications of transurethral contact pyelocalicolithotripsy.

scholarly journals Complications and relapses after alloplasty of large and giant hernia of the esophageal aperture of the diaphragm

2019 ◽  
Vol 18 (3) ◽  
pp. 192-202
Author(s):  
I. I. Rosenfeld
Keyword(s):  
Risk Factor ◽  
Surgical Treatment ◽  
Postoperative Complications ◽  
Medical Literature ◽  
Lightweight Mesh ◽  
Review Of The Literature ◽  
Main Risk Factor ◽  
High Incidence ◽  
Giant Hernia

The review of the literature presents the content analysis of surgical treatment of large and giant hernia of the esophageal aperture of the diaphragm as well as the analyses of complications when using the main methods of hernioplasty. Alloplasty of the esophageal aperture of the diaphragm remains a large and unresolved surgical problem, as evidenced by the analyzed literature sources, mainly reviews and clinical recommendations.Firstly, alloplasty can cause postoperative complications with a frequency of up to 20%, especially when using rigid polypropylene and composite polytetrafluoroethylene mesh implants with circular paraesophageal fixation. Modern biological nets now show high incidence of anatomical relapses, so most specialists continue to use synthetic implants, of which the most promising ones are lightweight, mesh, partially absorbable structures.Secondly, clear indications for alloplasty have not been developed, for example, according to the size of the hernia of the esophageal opening in the diaphragm, which is the main risk factor for relapses.Thirdly, it is still not clear what indicator should be used to estimate the size of hernia of the esophageal aperture of the diaphragm and, therefore, it is not clearly defined which hernias are considered small, which are large and which are giant, despite the fact that the three terms constantly appear in the medical literature.Fourthly, the optimal technique for alloplasty has not been determined with large and especially giant hernias, which would prevent anatomical relapses, and at the same time would not cause postoperative complications.It is necessary to outline the following ways to solve these problems: to develop effective and at the same time safe methods of alloplasty of large and giant hernias; to determine clear indications for alloplasty of the esophageal opening of the diaphragm, depending on the size of hernias; to create an appropriate, applied classification of hernias of the esophageal aperture of the diaphragm. 

Adenomyosis: diagnostics, tactics of treatment and rehabilitation of genesial function

2018 ◽  
pp. 30-32
Author(s):  
P.M. Prudnikov ◽  
Keyword(s):  
Health Care ◽  
Surgical Treatment ◽  
Key Words ◽  
Three Stages ◽  
Sterility Treatment

The objective: depression frequencies disturbances genesial function and gestational complications at| women with various forms of an adenomyosis on the basis of studying of new aspects of pathogenesis nodal and diffuse forms, and also development of algorithm of diagnostic, treatment-and-prophylactic and rehabilitational actions depending on an adenomyosis form. Materials and methods. Researches were conducted in three stages. At 1 stage 200 women of genesial age with an adenomyosis who addressed for surgical treatment in unit of operational gynecology were surveyed. At the 2nd stage of researches 100 women of genesial age who were operative concerning the sterility caused by existence of nodal or diffuse forms of an adenomyosis І and ІІ to degree were surveyed. To all patients sterility treatment with use of auxiliary genesial technologies – an extracorporal fertilization or ICSI was carried out. At the 3rd stage we studied features of a course of pregnancy and labors at 33 of 100 women (the 2nd stage) who had various programs of auxiliary genesial technologies. The complex of the conducted researches included clinical, ekhografical, dopplerometrical, endocrinologic, immunohistochemical, morphological, psychological and static methods. Results. Results of the conducted researches testify that the problem of conservation of genesial health at women with various forms of an adenomyosis is rather actual and conforms to all modern requirements. The algorithm of maintaining women developed by us with various forms of an adenomyosis, since well-timed diagnostics, expeditious treatment, rehabilitation of genesial function and finishing the course of pregnancy and labors allows to reduce the frequency of disturbances of genesial health at women of genesial age with an adenomyosis. Conclusion. The received results allow to recommend them for wide use in practical health care. Key words: adenomyosis, various forms, sterility, diagnostics, treatment, pregnancy, labors.

scholarly journals Prognostication of complications in patients with diseases of gallbladder after laparoscopic cholecystectomy

2020 ◽  
Vol 87 (7-8) ◽  
pp. 10-14
Author(s):  
М. А. Каshtalyan ◽  
А. E. Тkachenko ◽  
О. А. Кvasnevskiy ◽  
А.О. Коlotvin
Keyword(s):  
Risk Factors ◽  
Regression Analysis ◽  
Laparoscopic Cholecystectomy ◽  
Surgical Treatment ◽  
Postoperative Complications ◽  
Theoretical Substantiation ◽  
Scientific Practical ◽  
Premorbid State

Objective. To elaborate a prognostic classification of possibilities for occurrence of іntra- and postoperative complications, basing on determination of a premorbid state and the risk factors, concerning operative intervention in patients, suffering surgical diseases of gallbladder. Маterials and methods. Retrospective analysis of treatment of 911 patients, suffering cholelithiasis disease, оperated by the laparoscopic cholecystectomy procedure, was conducted, and factors of possibility of occurrence for іntra- and postoperative complications were determined with further establishment of their criteria. Results. The factors of risk for the complications occurrence after laparoscopic cholecystectomy in patients with diseases of gallbladder (n=911) were investigated. Prognostication pattern of the complications occurrence was built, taking into account the results of correlation-regression analysis conducted, and on its base the clinic-epidemiological groups of the complications risk were formatted with determination of their frequency of confidence intervals. Conclusion. Theoretical substantiation and scientific-practical decision of the task was presented, concerning raising of efficacy of miniinvasive operative interventions in patients with diseases of gallbladder, using elaborated methods of prophylaxis and surgical treatment of complications.

scholarly journals Combination of autoplasty with autodermoplasty in the treatment of lateral abdominal hernias

2012 ◽  
Vol 93 (2) ◽  
pp. 250-255
Author(s):  
A A Botezatu ◽  
I N Nurmeev
Keyword(s):  
Surgical Treatment ◽  
Abdominal Wall ◽  
State Institution ◽  
Case Histories ◽  
Treatment Results ◽  
Surgical Department ◽  
Lateral Abdominal Wall ◽  
New Methods ◽  
Abdominal Hernias

Aim. To improve the outcomes of treatment in patients with lateral abdominal hernias by combining autoplastic methods with autodermoplasty. Methods. 42 case histories of patients with lateral abdominal wall hernias, operated in the first surgical department of the State Institution «Republican Clinical Hospital», Tiraspol city, from 2001 to 2011 were subjected to retrospective analysis. In all of the cases surgical treatment was performed. Combined methods of hernioplasty, which combine autoplasty with autodermoplasty, were applied. The authors’ personal patented method of hernioplasty was also used among others. Results. According to the classification of Chevrel-Rath (2000) 23 (54.7%) of the patients had inferolateral hernias, 5 (11.9%) patients - supra-lateral hernias, 8 (19%) patients - lumbar hernias, there were also 2 (4.8%) patients each with transrectal, pararectal and paracolostomy hernias. Despite their small number in the total amount of postoperative hernias (17.5%), 26 (65%) patients had large and giant lateral hernias, while recurrences were present in 7 (16.7%) cases. Treatment results were satisfactory. Complications and recurrence occurred in 1 (2.9%) patient each. Conclusion. The combination of autoplasty with autodermoplasty is an effective method of treatment for inferolateral, supra-lateral, pararectal, transrectal, paracolostomy and lateral hernias; during lumbar hernias autodermoplasty even with two autodermal grafts was not as effective, and therefore justified is the search for new methods of hernioplasty.

Severity of Penetrating Eye Trauma in Children in Tajikistan

2020 ◽  
pp. 39-42
Author(s):  
K.M. Saidzhamolov ◽  
◽  
E.V. Gromakina ◽  
S.K. Makhmadzoda ◽  
◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Eye Injury ◽  
Case Histories ◽  
Second Child ◽  
National Medical ◽  
Eye Trauma ◽  
Penetrating Eye Injury ◽  
Eye Damage ◽  
The Republic ◽  
Large Wound

Purpose. To assess the severity of penetrating eye trauma in children in Tajikistan. Material and methods. Retrospectively there was analyzed 277 case histories of children with a diagnosis of penetrating eye injury, admitted to the children’s department of the National Medical Centre of the Republic of Tajikistan for the provision of specialized ophthalmological care. Results. The average age of children at the time of injury to the organ of sight was 7.06 ± 3.01 years, mainly these were villagers (70%). Children under 7 years old accounted for 57.8% of those admitted to the hospital. The terms of admission to the hospital ranged from 1 to 14 days, an average of 43.02 ± 33.35 hours. The severity is caused by damage to 2 or more structures of the eyeball in 81,3%. Wounds larger than 6 mm prevailed and amounted to 63,5%. Endophthalmitis at admission was noted in 8,3% of cases. Enucleation was performed in 2 children; 244 children underwent primary surgical treatment. Visual acuity at discharge was higher than 0.1 in 72 of 275 children (26.2%), lower than 0,1 in 194 (70.7%). Conclusion. Almost every second child (43.0%) is admitted to the hospital for primary surgical treatment of an eyeball wound after 24 hours. About 2/3 of cases of eye damage are characterized by large wound sizes. Stab wounds were noted in 90.2% of cases. In 58.8% of cases, damage to the cornea was observed and in 68.6% – damage to the lens area.

Temporary “liquid” Implant for Congenital Glaucoma (long-term results)

2020 ◽  
pp. 49-65
Author(s):  
N Bobrova ◽  
N Trofimova
Keyword(s):  
Surgical Treatment ◽  
Postoperative Complications ◽  
Hypotensive Effect ◽  
Congenital Glaucoma ◽  
Long Term Results ◽  
General Will ◽  
Visual Functions ◽  
Advanced Stages ◽  
Intraocular Fluid

The aim of the work was to analyze the long-term results of using a temporary “liquid” implant in the surgery of congenital glaucoma in children. The basis of the developed method of filtrative antiglaucomatous surgery (Patent of Ukraine No. 45099 of 2009) – viscosinusotrabeculotomy – has been set the task of reducing the risk of developing intra- and postoperative complications, reducing the scarring rate and maintaining the newly created ways of the intraocular fluid outflow, which in general will increase the effectiveness of surgical treatment of congenital glaucoma in children. 54 children (91 eyes) with simple congenital glaucoma at the age of 1 to 36 months were operated on average (8.7 ± 8.2) months. The persistent and long-lasting hypotensive effect achieved due to viscosinusotrabeculotomy in children with developed and far-advanced stages of congenital glaucoma stops the processes of stretching of the membranes of the eye and stabilizes their size, which in general allows preserving and visual functions improving, in infancy – creating conditions for their formation.

EFFICACY OF ENDOSCOPIC HEMOCLIPS AND INTERMITTENT INTRAVENOUS PPI IN PEPTIC ULCER BLEEDING

2019 ◽  
pp. 40-44
Author(s):  
Van Huy Tran ◽  
Duy Lieu Dinh
Keyword(s):  
Peptic Ulcer ◽  
Key Words ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Ulcer Bleeding ◽  
Peptic Ulcer Bleeding ◽  
Forrest Classification

Background: Efficacy of continuous intravenous proton- pump inhibitors (IV PPI) and hemoclips alone was proved, but data about combination of an application of endoscopy clips and intermittent IV PPI in Vietnam was still limited. This study aimed to assess the efficacy of endoscopy hemoclip combined with intermittent IV PPI in the patients of peptic ulcer bleeding. Patients and methods: 34 patients diagnosed as peptic ulcer bleeding, having Forrest classification of Ia, Ib, IIa and IIb, were enrolled. Esomeprazole was administered as 80 mg IV bolus followed by intermittent IV injection of 40 mg/8h during 72h. Results: Immediate hemostasis was achieved in all 34 patients. Only 1 patient (2.9%) had early rebleeding. No severe complications was found in this study. Conclusion: Combination of endoscopy hemoclips and intermittent PPI showed effective, safe in patients of peptic ulcer bleeding. Key words: Peptic ulcer bleeding, intermittent PPI, endoscopy hemoclip

PREDICTIVE FACTORS IN THE CHOICE OF SURGICAL TREATMENT FOR COLORECTAL CANCER WITH LAPAROSCOPIC OR "OPEN" ACCESS

2017 ◽  
Vol 63 (3) ◽  
pp. 470-474
Author(s):  
Rustem Topuzov ◽  
Georgiy Manikhas ◽  
Eskender Topuzov ◽  
Mikhail Khanevich ◽  
Magomed Abdulaev ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Surgical Treatment ◽  
Postoperative Complications ◽  
Open Access ◽  
Comparative Study ◽  
Retrospective Analysis ◽  
Predictive Factors

There are presented results of surgical treatment of 347 patients with colorectal cancer. Based on the retrospective analysis a comparative study of results of surgical treatment for colorectal cancer using laparoscopic technologies and “open” access was carried out. Predictive factors that correlate with the risk of postoperative complications with laparoscopic and “open” access at the surgical stage of treatment for colorectal cancer were determined.

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