The Use of Bromfenac Ophthalmic Solution in Clinical Practice (Literature Review)

To this date nonsteroidal anti-inflammatory drugs play a huge role in the treatment of inflammatory eye diseases. Ophthalmologists face the question of choosing between glucocorticoid drugs (GCS) and nonsteroidal anti-inflammatory drugs (NSAIDs) for the treatment of any inflammatory process. At the same time, these groups can be used both in combinations and in monotherapy mode. Glucocorticoids are widely and effectively used in ophthalmology, but it should be remembered about a number of serious side effects of this group of drugs. When using these drugs, it is possible to increase ophthalmotonus, decrease the immune response and reparative processes, also GCS have cataractogenic and ulcerogenic effects, and therefore it careful use is necessary. NSAIDs are inferior to glucocorticoids in anti-inflammatory activity. Its mechanism of action is associated with blocking cyclooxygenase, inhibition of prostaglandin synthesis from arachidonic acid. In this regard, NSAIDs are the preferred group in the treatment of inflammatory eye diseases. The use of NSAIDs gives a good analgesic effect, this class of drugs is effective for the prevention of macular edema of various etiologies and reducing the risk of inflammation in the postoperative period. One of the most effective and most modern NSAIDs for topical use is a derivative of phenylacetic acid — Bromophenac, which in its formula has a bromine atom, which increases its lipophilicity, penetrating ability into the tissues of the eye, as well as analgesic and anti-inflammatory activity. Bromfenac is effective for relieving pain and all signs of inflammation caused by disease or surgery, suppressing the development of macular edema of various etiologies, has an antimiotic effect. Also, this group can be used after refractive surgery to reduce pain and photophobia, to relieve itching in allergic conjunctivitis. Double use of this drug during the day, the absence of discomfort and minimal side effects contribute to improving the patient’s compliance.

Prolonged QT interval syndrome in pediatric practice: literature data and clinical case description

The article provides basic information about the syndrome of prolonged QT interval, which is a rare pathology of the cardiovascular system and can cause sudden death. The mutations in the genes responsible for dysfunction of ion channels are the key in the pathogenesis of this disease. Jerwell and Lange—Nielsen, Romano—Ward, Andersen—Tavil and Timothy syndromes are described as the main hereditary variants of this syndrome. A own case of the disease in a patient was given. The peculiarity of this case was on the acute, atypical onset of the disease, which started with convulsions and sudden cardiac death. The clinical picture of this case, features of a current are described, indicators of the basic methods of research are resulted. Information on the treatment of this clinical case at the local level and in the department of surgical treatment of arrhythmias, where the patient underwent implantation of endocardial bicameral cardioverter-defibrillator, іs presented. Data on further observation and treatment of the child at the place of residence are given. The research was carried out in accordance with the principles of the Helsinki declaration. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: syndrome, QT interval, etiology, pathogenesis, clinical picture, diagnosis, examination, treatment.

Experience of using Rituximab in neurological practice (literature review and own observation)

Currently, due to the lack of specific etiotropic therapy, rituximab is widely used for the treatment of most autoimmune diseases of the central and peripheral nervous system. Rituximab is a chimeric monoclonal antibody with specificity for CD20, the antigen found on the surface of normal and malignant B-lymphocytes. It is used mainly in hematological practice. It is used off-label for the treatment of neurological diseases. The world literature describes the use of rituximab for the treatment of such pathologies as autoimmune encephalitis, neuromyelitis optica spectrum disorder, multiple sclerosis, primary angiitis of the central nervous system, immune-mediated inflammatory polyneuropathy, myasthenia gravis, refractory to basic immunosuppressive therapy. This article provides an overview of the world literature on the use of rituximab in neurological practice, describes our own experience of its use on the basis of the Department of Neurology № 1 of Pavlov University (Saint Petersburg, Russia).

Cardiac Troponins Metabolism: From Biochemical Mechanisms to Clinical Practice (Literature Review)

The metabolic processes of endo- and exogenous compounds play an important role in diagnosing and treating patients since many metabolites are laboratory biomarkers and/or targets for therapeutic agents. Cardiac troponins are one of the most critical biomarkers to diagnose cardiovascular diseases, including acute myocardial infarction. The study of troponin metabolism is of great interest as it opens up new possibilities for optimizing laboratory diagnostics. This article discusses in detail the key stages of the cardiac troponins metabolism, in particular the mechanisms of release from a healthy myocardium, mechanisms of circulation in the bloodstream, possible mechanisms of troponin penetration into other biological fluids (oral fluid, cerebrospinal fluid, pericardial and amniotic fluids), mechanisms of elimination of cardiac troponins from the blood, and daily changes in the levels of troponins in the blood. Considering these aspects of cardiac troponin metabolism, attention is focused on the potential value for clinical practice.

EP.TU.443Improving the Skills and Safety at Workplace: Training on the Use of the AirSeal Insufflation System in Laparoscopic Surgery

Aims According to Good Surgical Practice set by the RCS England, surgeons need to keep themselves up to date and maintain the competence in all areas of their practice. Literature and guidelines recommended the use of AirSeal insufflation in laparoscopic surgery for the safety during the first surge of Covid-19. Our objectives were to measure the level of knowledge and confidence of surgical trainees in using the AirSeal insufflation system in laparoscopic surgery at our institution and to help trainees achieve competence. Method Multiple small group training sessions were delivered to 14 surgical doctors adhering to safety protocols. The concept of the AirSeal insufflation system, its benefits, limitations, set up and troubleshooting were delivered using lectures, videos and hands-on training. The change in level of knowledge and confidence in practical skills were assessed by analyzing the responses to the questionnaire completed before and after the course. Results Conclusion The dramatic improvement in self-perceived confidence of practical skills and knowledge of the AirSeal system was achieved among surgical doctors. Adaptation to the situation and introduction of this advanced technology to the trainees in elective and emergency settings helped promote the skills and safety at workplace during this pandemic especially with the support of flexible training sessions.

Human rights to the street: Ethical frameworks to guide planning, design, and engineering decisions toward livability, equity, and justice

Recently, there has been a renewed interest in statements about people’s rights to our streets. Drawing broadly from the literature and from an examination of a comprehensive collection of these rights, this article works toward establishing a comprehensive ethical framework that can be used to guide planning, design and engineering decisions to support pedestrian rights for street and urban livability. To identify and propose these ethical principles and help achieve optimal livability for individuals, groups and society, we: (a) comprehensively examine the literature to clarify the various concepts of street livability and human rights to the street (as related to a collection of various pedestrian rights statements); (b) explore what is being said in these rights to better understand people’s needs and wants; and (c) provide a roadmap for planners, urban designers, and engineers to address these needs in practice. Building on the previous steps and incorporating business practice literature of Functional Area Ethics, relevant functional areas are identified to help professionals act in support of these pedestrian rights.

Uso de Alinhadores Invisalign na Prática Ortodôntica: Revisão de Literatura / Use of Invisalign Aligners in Orthodontic Practice: Literature Review

RESUMO: O objetivo consiste na elaboração de uma revisão bibliográfica acerca dos alinhadores estéticos ortodônticos, suas vantagens e desvantagens, benefícios e limitações. Classifica-se como uma revisão bibliográfica de caráter exploratório acerca da utilização de alinhadores invisaling®, através de buscas nas plataformas: Pubmed, Google Acadêmico e Scielo, Lilacs e Bireme, aplicando como filtro principal artigos publicados entre 2016 a 2021. A buscas realizadas totalizaram 138 artigos, que após a leitura do título, leitura do resumo e leitura total do conteúdo, permitiu a seleção 30 artigos. Conclui-se que os alinhadores invisalign® se trata de um recurso revolucionário para ortodontia estética, tendo em vista a sua estrutura conformacional, além de demonstrar eficiência no tratamento ortodônticos de maloclusões leves ou moderadas, porém suas limitações relacionam-se a casos severos que apresentem necessidade de expansão do arco através da movimentação dentária corporal, fechamento de espaços após exodontias, ajustes oclusais e em casos de discrepâncias ântero-posteriores verticais.

Policy in Practice: Social Procurement Policies in the Swedish Construction Sector

Procurement has long been used to fulfil policy goals, and social procurement policies can mitigate issues connected to social exclusion, unemployment and segregation. The target groups for such policies are disadvantaged people such as immigrants, young people and people with disabilities. Due to its close connection to exclusion and segregation issues, the construction and real estate sector has often been seen by policymakers as an appropriate sector for social procurement. However, practices to implement such policies are underdeveloped, which creates uncertainty and hinders the transition towards sustainability in the construction sector. This paper investigates how construction clients and contractors perceive the implementation of social procurement policies in practice. Drawing on policy-in-practice literature and interviewing 28 actors in the Swedish construction sector, the findings show a misalignment between: (1) social procurement policies, (2) the sector and its existing practices, and (3) the target group and their skills and needs. Although this misalignment adversely impacts policy implementation and practice formation, it can likely be mitigated if actors co-create policy goals and practices that mesh with existing practices, and provide more resources to enable policy implementation. This paper shows how procurement can help fulfil social policies and the difficulties of achieving that in practice.

Ocimum Species: Ethnomedicinal Uses, Phytochemistry and Pharmacological Importance

Plant species belonging to the Ocimum genus are among the most popular medicinal plants and are being used for several purposes in ethnomedicine. Ocimum is universally cultivated however; the geographical distribution highlights three major centers of Ocimum diversity, these are: the tropical areas of America, the tropical region of Asia and the tropical and subtropical regions of Africa. Ocimum species have been employed traditionally for several medicinal purposes including antioxidant, antibacterial, hypoglycaemic, hepatoprotective, antiviral and other medicinal purposes. Though scientists have carried-out studies and chronicled the pharmacological potentials of Ocimum species, documents containing these data seem to be disassembled, making it difficult to really distinguish the pharmacologically useful species from those that are not and also to get comprehensive information about the medicinal species in this genus. Hence, the aim of this review is to outline classified information on the ethnopharmacology, phytochemistry and pharmacological importance of some Ocimum species that have been reported by different researchers. In carrying-out this review, the search for literature was done via relevant databases including PubMed, Springer, Web of Science, Science Direct, Embase, SciFinder, Google Scholar and Scopus. The species reviewed are the most widely used from the Ocimum genus in traditional medicine and they are also the most researched for intended use in conventional therapeutic practice. Literature reveals that these species contain several compounds which are responsible for the numerous pharmacological activities elicited by them including antimalarial, anticancer, antidiabetic, antiinflammatory and antioxidant effects.