Пути совершенствования исследования качества жизни пациента в офтальмологии — мировые тенденции и собственный опыт

   Improving the methodology for assessment of the "quality of life" (QoL) of patients in ophthalmic practice is a regular process aimed at increasing the efficiency of clinical diagnostic examination. An analysis of how the quality of life assessment methodology is being improved in the practice of foreign ophthalmologists reveals two interrelated areas — the introduction of various methods of mathematical analysis in order to confirm the content and constructive validity of the developed questionnaire, as well as the wider distribution of approved questionnaires based on adaptation to a specific state language. The accumulated experience of the authors indicates that the involvement (as experts) of ophthalmologists in the development of a QоL questionnaire, as well as the optimal procedure for scaling patient responses, are effective ways to improve the methodology for assessing QoL, which is confirmed by an assessment of the original QoL questionnaires designed for patients with vitreoretinal pathologies, computer vision syndrome and cataracts.   Совершенствование методики оценки «качества жизни» пациента (КЖ) в офтальмологической практике является закономерным процессом, направленным на повышение эффективности клинико-диагностического обследования пациента. Анализ совершенствования методики оценки КЖ в практике зарубежных офтальмологов указывает на два взаимосвязанных направления: внедрение различных методов математического анализа с целью подтверждения содержательной и конструктивной валидности разработанного опросника и более широкое распространение апробированных опросников на основе адаптации к конкретному государственному языку. Накопленный авторский опыт указывает, что привлечение (в качестве экспертов) врачей-офтальмологов к разработке опросника КЖ, а также оптимальная процедура шкалирования ответов пациента являются эффективными направлениями совершенствования методики оценки КЖ, что подтверждается проведенной оценкой оригинальных опросников КЖ пациента при витреоретинальной патологии, компьютерном зрительном синдроме и катаракте

Risk Factors of Severe Disease and Methods for Clinical Outcome Prediction in Patients with COVID-19 (Review)

Large population studies using statistical analysis and mathematical computer modeling could be an effective tool in studying COVID-19. The use of prognostic scales developed using correlation of changes in clinical and laboratory parameters and morphological data, can help in early prediction of disease progression and identification of patients with high risk of unfavorable outcome.Aim of the review. To assess the risk factors for severe course and unfavorable outcome of COVID-19 and to evaluate the existing tools for predicting the course and outcome of the novel coronavirus infection. PubMed, Medline, and Google Scholar were searched for the relevant sources. This review contains information on existing tools for assessing the prognosis and outcome of the disease, along with the brief data on the etiology, pathogenesis of the novel coronavirus infection and the known epidemiological, clinical and laboratory factors affecting its course.Conclusion. It is essential to develop predictive models tailored to specific settings and capable of continuous monitoring of the situation and making the necessary adjustments. The discovery of new and more sensitive early markers and developing marker-based predictive assessment tools could significantly impact improving the outcomes of COVID-19

Факторы риска и методы прогнозирования клинического исхода COVID-19 (обзор)

Large population studies using statistical analysis and mathematical computer modeling could be an effective tool in studying COVID-19. The use of prognostic scales developed using correlation of changes in clinical and laboratory parameters and morphological data, can help in early prediction of disease progression and identification of patients with high risk of unfavorable outcome.Aim of the review. To assess the risk factors for severe course and unfavorable outcome of COVID-19 and to evaluate the existing tools for predicting the course and outcome of the novel coronavirus infection. PubMed, Medline, and Google Scholar were searched for the relevant sources. This review contains information on existing tools for assessing the prognosis and outcome of the disease, along with the brief data on the etiology, pathogenesis of the novel coronavirus infection and the known epidemiological, clinical and laboratory factors affecting its course.Conclusion. It is essential to develop predictive models tailored to specific settings and capable of continuous monitoring of the situation and making the necessary adjustments. The discovery of new and more sensitive early markers and developing marker-based predictive assessment tools could significantly impact improving the outcomes of COVID-19.Одним из эффективных инструментов изучения COVID-19 является исследование больших популяций пациентов и выделение факторов, влияющих на течение и прогноз, с помощью различных методов статистического анализа и математического компьютерного моделирования. Применение прогностических шкал, разработанных на основании сопоставления динамики клинических и лабораторных показателей с морфологическими данными, может помочь в своевременной оценке возможных вариантов течения заболевания и выделении больных группы высокого риска неблагоприятного исхода.Цель обзора. Оценить факторы риска тяжелого течения и неблагоприятного исхода COVID-19, существующие инструменты прогнозирования течения и исхода новой короновирусной инфекции. Поиск источников осуществляли в базах данных PubMed, Medline, Google Scholar. Данный литературный обзор наряду с краткими данными об этиологии, патогенезе COVID-19 и об известных эпидемиологических, клинических и лабораторных факторах, влияющих на ее течение, содержит информацию о существующих инструментах оценки прогноза течения и исхода заболевания.Заключение. Необходима разработка прогностических моделей, созданных под конкретные условия с возможностью постоянного мониторинга ситуации и внесения корректировок при необходимости. Обнаружение новых более чувствительных на ранних этапах заболевания маркеров и разработка на их основе инструментов оценки прогноза могло бы значительно улучшить исходы COVID-19

Primjena i kompozicija individualiziranih zaštitnih elemenata linijske grafike u projektiranju novčanica

Proces stvaranja novčanica je dugotrajan i složen, što rezultira kompleksnim rješenjima koja predstavljaju pravo remek djelo grafike. Novčanice su prožete brojnim detaljima i prenose različite informacije koje se analiziraju u teorijskom dijelu rada. Prvotno se postavljaju kriteriji po kojima se izrađuje detaljna analiza velikog broja zaštitnih i konceptualnih elemenata na primjerima novčanica. Time je prikazan okvirni povijesni pregled razvoja novčanica i utjecaji kojima je bio izložen. Analizira se međuovisnost dizajna o sigurnosnim značajkama, te se ispituje razina informiranosti javnosti o zaštitama na novčanicama. Zaključuje se koje metode zaštite su najučinkovitije, te kako šira javnost najčešće provjerava autentičnost novčanica. U eksperimentalnom dijelu rada se na temelju donesenih zaključaka iz teorijskog dijela izrađuje prototip novčanice koja je u najvećoj mjeri prožeta individualiziranim PostScript programskim rješenjima elemenata linijske grafike (rozete, mikrotekst, zaštitne linije, brojevi apoena), a od ostalih zaštita modeliran je individualizirani raster transformacijom matematičkog izraza u PostScript programski kod. Sve ostale zaštite tipične za novčanice simulirane su alatima za rastersku i vektorsku grafiku. U radu se ispituje utjecaj kompozicije zaštitnih elemenata na prepoznavanje autentičnosti novčanica, te efikasnost samih individualiziranih programskih rješenja

Development and Evaluation of Clinical Efficacy of Intraocular Lens Fixation after Cataract Phacoemulsification, Complicated by Capsular Lenticular Disruption

Рurpose. Evaluation of the clinical efficacy of the original procedure for fixing the posterior chamber intraocular lens (IOL) after phacoemulsification of cataracts (FEC), complicated by the violation of capsular lens support.Patients and Methods. 194 patients were examined after FEC,  complicated by a capsular lenticular impairment. They were divided  into 3 groups. In the main group (OG, 64 eyes) the IOL was sutured  with an original technique, fundamentally different method, there  nodes formed at the ends of the filaments were fixed in the layers of the cornea. In 2 controls groups, there the traditional IOL under  the scleral flap (K1, 68 eyes) was performed and the IOL was  attached to the iris (K2, 62 eyes). A comprehensive examination of  the patients’ vision state included an evaluation of clinical, functional and subjective indicators.Results. The lowest total probability of postoperative complications development was noted in OG (6.4%) compared to K2 and K1  (16.0–17.7%). The overall probability of changing the positions of  the IOL in the exhaust gas is 6.4%, which is significantly lower than  in the K2 (9.6%) and K1 (14.6%) groups. The developed method in  comparison with the traditional methods of fixation provides a higher level of patient’s quality of life (by 10.2–11.7%, p < 0.05)  and functional indicators associated with the brightness and contrast sensitivity of the eye.The conclusion. The developed technique provides, in comparison with the traditional, a higher level of safety and functionality of IOL fixation

Main principles of the development of the life quality evaluation methods in the case of vitreoretinal pathology

The aim of the study was to develop a methodology for assessing the quality of life in patients with different types of vitreoretinal pathology. The first stage is detection of target group, collection data of diseases, choosing the key features and principles of valuation developed questionnaire. The detailed list of questions, determination the type of questionnaire, method of data collection, as well as developing (if necessary) scaling system (indexation) of answers is made on the second stage. The preliminary version of questionnaire on the base on 2 first stage. At the final stage of development assess the reliability, validity and sensitivity of the method of construction with the possibility of some modification of both the questionnaire and psychometric evaluation of the parameters of the test should be accessed. We conducted a broad survey of 28 experts-ophthalmologists (mean age 42.4 years), with extensive experience as a general clinical practice (average work experience is 20.4 years), and immediate surgical operation in the field of medical and surgical treatment of patients with various types of vitreoretinal pathology. The list of suggested questions for patients (total 37 questions), and the time of occurrence of the symptom criteria for psychometric scale responses was presented to the every expert. The choice of psychometric rating scale is (along with the definition of specific issues) the basic methodological position of developing the questionnaire. The most appropriate time scaling with the month period. Therefore the answers were presented in the the form of «permanent», «once a day», «every week», «every month», «absent». From a practical point of view it is extremely important to the The consideration of a quantitative estimation of the responses is extremely important from the practical point of view

The study of the daily dynamics of the accommodative function of the eye

Purpose: to study the dynamics of the volume was an accommodation during the day.Methods: We investigated the amount of accommodation in 36 patients (men aged 25-30 years) without pathology of the vision five times during the day.Results: the highest rates were observed in the amount of accommodation from 12 to 16 hours, the maximum oscillation is 1.34 D or 24.3%.Conclusion: the analysis of the accommodative function of the various problems of ophthalmology and alternative specialties (neurology, rehabilitation medicine, etc.) must be compared the identified changes in the state of the accommodative apparatus of an eye to possible biological rhythms during the day

Comparative Evaluation of the Different Assessment Methods of Life Quality in Patients with Vitreoretinal Pathology

Effectiveness of the patients with the vitreoretinal pathology with different quality of life (QL) comparative evaluation methods. Methods. 129 patients (before and after standard vitrectomy) with the 3 types of the vitreretinal pathology were examined (38 — with intraocular hemorrhage, 43 — proliferative diabetic retinopathy (PDR), 48 — retinal detachment). Complex examination (36 clinical, haemodynamic and electrophysiological indications) were performed before and 1 month after surgery. QL research was based on the QL-25 (Russian type of the VFQ-25), QL-9 (Russian type of VF-14) and authorial QL-20 questionnaire. Results. QL increasing was detected after the surgery (15.8–20.9%) in all cases of the vitreoretinal pathology type. Correlation analysis of the different QL hasshown obvious QL-20 advantages, comparing to QL-9 and mostly QL-25, that was indicated by the statistically significant difference of the middle (all 36 indicators) KK (0,44±0,02; 0,35±0,02; 0,15±0,03) and higher KK relating to prognostic informative vision indicators (0,75–0,84; 0,69–0,74; 0,21–0,70). Conclusion. Results indicate actuality of the QL-20 method adaption in dispensary observation of the patients with different types of vitreoretinal pathology