The history of keratoprosthetics in the S. Fyodorov Eye Microsurgery Federal State Institution

ABSTRACT The article highlights a 45-year experience in keratoprosthetics at the S. Fyodorov Eye Microsurgery Federal State Institution. During this period, more than 1,000 keratoprostheses of different types has been implanted. The design features, advantages and disadvantages of foreign keratoprosthesis – Choyce-1, Choyce-2, H. Cardona «bolt-nut», which were used in the clinic in the first stages of prosthetics of the cornea, are described. There are presented the basic requirements for penetrating keratoprosthesis, which inspired the creation of the own original models of corneal prostheses: Fyodorov-Zuev, Moroz-Glazko, «Mesh», biokeratoprosthesis. This article describes surgical techniques of implantation of various keratoprostrhesis designs in case of thin, irregular leucomas using the method of simultaneous penetrating keratoplasty and keratoprosthesis – the transplantation of corneal-prosthetic complex. Intra- and postoperative complications are mentioned as well as methods of their prophylaxis and management. In the paper there are also noted different operations performed simultaneously with keratoprosthesis

Reconstruction of anterior segment of the eye with simultaneous transplantation of a corneal prosthesis complex in case of burn leucoma of category 5 (a case report)

ABSTRACT Purpose. Analysis of results in optical reconstructive surgery in structures of anterior ocular segment with a simultaneous transplantation of corneal prosthetic complex in a patient with burn vascular leucoma of the category 5. Material and methods. In patient (male, age 50 years) with burn vascular leucoma of the category 5 after multiple attempts of keratoprosthesis during 9 years a simultaneous reconstruction of anterior segment with a transplantation of corneal prosthetic complex was performed. Results. The operation and the postoperative course were without complications. A visual acuity increase with stabilization up to 0.03 was noted in control examinations during the whole follow-up (11 months). Objectively in an analogous postoperative period the keratoprosthesis had a correct and stable position in the corneal layers without any signs of superficial leucoma layers necrosis. Conclusions. The reconstruction of anterior segment with a transplantation of corneal prosthetic complex increases a quality and results of operation, provides a long maintenance of achieved visual functions, increasing a life quality of patients, decreases a risk of postoperative complications and a necessity of repeated surgical interventions

Биохимические, коронароангиографические и эхокардиографические показатели при нижнем остром инфаркте миокарда с поражением правого желудочка

Background: The involvement of the right ventricular (RV) myocardium in inferior acute myocardial infarction (AMI) increases the risk of complication and death rates, which makes it important to timely identify this type of myocardial infarction. Aim: To assess the value of functional, biochemical, coronary angiographic and ultrasound parameters in the patients in their productive age with inferior AMI, in order to identify the RV injury before and after percutaneous coronary intervention (PCI). Materials and methods: This cohort prospective study included 141 patients with inferior AMI and ST elevation (26 women aged up to 60 years and 115 men aged up to 65 years), admitted to the emergency of the Medical Unit of Kazan (Volga region) Federal University from 2019 to 2021. The patients past history, clinical, biochemical and ultrasound data were obtained on admission and at discharge from the hospital. The two-dimensional speckle tracking echocardiography was performed at days 5 to 7 after PCI. The results are given as median values and 25% and 75% quartiles (Ме [Q1; Q3]). Results: According to electrocardiographic signs, 41.8% (n = 59) patients with inferior AMI comprised the group with the RV injury. There were no differences in the myocardial injury biomarker levels between the groups on admission (р = 0.31 and p = 0.786, respectively). The coronary angiography showed that the index artery was the right coronary artery in 100% (n = 59) cases with the RV injury and in 67.1% (n = 55, р 0.001) of the cases without the RV injury. Proximal involvement was 2.7 more common in biventricular infarction, than in the isolated inferior one (р = 0.013). During PCI, the RV involvement significantly increased the risk of complications (in 28 (47.5%) and 18 (22.0%) of the cases, respectively, р 0.001), among them being the need in a temporary pacemaker placement (8 (13.6%) and 2 (2.4%) patients, р = 0.027). Echocardiography showed worse parameters of global and local contractility of both ventricles in the group with the RV involvement in the inferior AMI. The left ventricular (LV) ejection fraction decreased from 55% [51; 57] to 52% [47; 56] (р = 0.005); global RV deformity from -15.2% [-18.5; -13.4] to -12.3% [-15.6; -10.6] (р 0.001); total number of segments with local contractility abnormalities increased from 2 [1; 3] to 5 [3; 6] (р 0.001). Conclusion: The study has confirmed that the involvement of RV into inferior LV AMI in the patients of productive age should be verified by abnormalities of electrocardiographic, biochemical, coronary angiographic and ultrasound parameters. To document the RV injury before PCI, ST elevation in additional right chest leads (V3RV4R) was most informative, whereas after PCI, it was the finding of abnormal local contractility of basal and medial inferior RV segments by two-dimensional echocardiography and decreased longitudinal RV deformation by speckle tracking.Актуальность. Вовлеченность миокарда правого желудочка (ПЖ) при нижнем остром инфаркте миокарда (ОИМ) повышает вероятность осложнений и летальность, определяя важность своевременного выявления данного варианта инфаркта. Цель оценить значимость функциональных, биохимических, коронароангиографических и ультразвуковых показателей у пациентов трудоспособного возраста при нижнем ОИМ для выявления поражения ПЖ до и после чрескожного коронарного вмешательства (ЧКВ). Материал и методы. В когортное проспективное исследование включен 141 пациент с нижним ОИМ с подъемом сегмента ST (26 женщин в возрасте до 60 лет и 115 мужчин в возрасте до 65 лет), экстренно госпитализированный в Медико-санитарную часть Казанского (Приволжского) федерального университета в 20192021 гг. Клинико-анамнестические, биохимические и эхокардиографические показатели пациентов были получены при поступлении и выписке из стационара. Эхокардиографию в двумерном режиме с использованием технологии спекл-трекинг проводили на 57-е сутки после ЧКВ. Результаты исследований представлены в виде медианы и 25%75% квартилей (Ме [Q1; Q3]). Результаты. По электрокардиографическим признакам 41,8% (n = 59) пациентов с нижним ОИМ вошли в группу с поражением ПЖ. Концентрации биомаркеров поражения миокарда между группами при поступлении не различались (р = 0,31 и p = 0,786 соответственно). Согласно коронароангиографии, инфаркт-связанной артерией была правая коронарная артерия в 100% (n = 59) случаев при поражении ПЖ и в 67,1% (n = 55, р 0,001) случаев без него. Поражение проксимального отдела в 2,7 раза чаще наблюдали при бивентрикулярном инфаркте, чем при изолированном нижнем (р = 0,013). Во время ЧКВ вовлечение ПЖ значимо повышало вероятность осложнений (в 28 (47,5%) и 18 (22,0%) наблюдениях соответственно, р 0,001), прежде всего необходимости установки временного электрокардиостимулятора (у 8 (13,6%) и 2 (2,4%) пациентов, р = 0,027). По данным эхокардиографии худшие показатели глобальной и локальной сократимости обоих желудочков были в группе с вовлечением в нижний ОИМ ПЖ: фракция выброса левого желудочка (ЛЖ) снижалась с 55% [51; 57] до 52% [47; 56] (р = 0,005); глобальная деформация ПЖ с -15,2% [-18,5; -13,4] до -12,3% [-15,6; -10,6] (р 0,001); общее количество сегментов с нарушением локальной сократимости возрастало с 2 [1; 3] до 5 [3; 6] (р 0,001). Заключение. Проведенное исследование подтверждает, что вовлеченность ПЖ в нижний ОИМ ЛЖ у людей трудоспособного возраста следует верифицировать по изменениям электрокардиографических, биохимических, коронароангиографических и ультразвуковых показателей. Для верификации поражения ПЖ решающее значение до проведения ЧКВ имела регистрация элевации сегмента ST в дополнительных правых грудных (V3RV4R) электрокардиографических отведениях, после ЧКВ визуализация нарушения локальной сократимости базальных и медиальных нижних сегментов ПЖ по двумерной эхокардиографии и снижения продольной деформации ПЖ по технологии спекл-трекинг

TREATMENT OF INFANTS WITH REPEATED BACTERIAL INFECTIONS OF RESPIRATORY TRACT AND ENT-ORGANS WITH LYSATES MIXTURE

The article presents the results of a study, evaluating effectiveness of therapeutic use of bacterial lysates for the topical administration (IRS 19) in children under the age 3–9 months old. All children had repeated bacterial diseases of ENT-organs and respiratory tract; it is the clinical sign of immunological reactivity disorder in infants, which is estimated as so-called «syndrome of anti-infection defense disorder». Administration of drug resulted in decrease of rate and duration of infectious episodes in upper and lower airways, excluded the need of antibacterial treatment of these children. This effect is concerned with increase of resistance of children’s organism and indirect correction of previously detected immune disorders.Key words: infants, infections of respiratory tract, disorders of anti-infection defense, bacterial lysates mixture.(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(5):40-46

Efficacy of Dasatinib in a CML Patient in Blast Crisis with F317L Mutation: A Case Report and Literature Review

The introduction of tyrosine kinase inhibitors (TKIs) in the treatment of chronic myeloid leukemia (CML) has significantly increased survival rate and quality of life for patients with CML. Despite the high efficacy of imatinib, not all patients benefit from this treatment. Resistance to imatinib can develop from a number of mechanisms. One of the main reasons for treatment failure is a mutation in the BCR-ABL gene, which leads to therapy resistance and clonal evolution. Clearly, new treatment approaches are required for patients who are resistant to imatinib. However, mutated clones are usually susceptible to second-generation TKIs, such as nilotinib and dasatinib. The choice of the therapy depends on the type of mutation. A large trial program showed that dasatinib is effective in patients previously exposed to imatinib. However, for a minority of patients who experience treatment failure with TKI or progress to advanced-phase disease, allogeneic stem cell transplantation (allo-SCT) remains the therapeutic option. In spite of the high curative potential of allo-SCT, its high relapse rate still requires a feasible strategy of posttransplant treatment and prophylaxis. We report a case of a CML patient with primary resistance to first-line TKI therapy. The patient developed an undifferentiated blast crisis. Before dasatinib therapy, the patient was found to have an F317L mutation. He was successfully treated with dasatinib followed by allo-SCT. In the posttransplant period, preemptive dasatinib treatment was used to prevent disease relapse

Human as the protector of creation

© 2020, Slovenska Vzdelavacia Obstaravacia. All rights reserved. The biblical vision focuses on several different concepts of the role of humanity in the world. The authors concentrate on a model of the biblical myth of Adam, who is charged with ruling over other creatures and protecting them from danger. This model, which comes from the older mythical fabric of the ancient Near East, is then transformed both theologically and ethically in a Hellenistic era. It is from the end of the Hellenistic period that the New Testament texts about Adam and Christ appear. The article continues to focus on the shape of the human-creature relationship, focusing on the current world and the social problems created by the insufficient protection of the world. The subsequent challenges come from biblical paradigms: humanity as protector, wise housekeeper and caretaker. The authors work with particular regard to the Christian paradigms, but they will also mention in passing the current models in force in Judaism and Islam

Human as the protector of creation [Clovek jako ochrance stvoreni]

The biblical vision focuses on several different concepts of the role of humanity in the world. The authors concentrate on a model of the biblical myth of Adam, who is charged with ruling over other creatures and protecting them from danger. This model, which comes from the older mythical fabric of the ancient Near East, is then transformed both theologically and ethically in a Hellenistic era. It is from the end of the Hellenistic period that the New Testament texts about Adam and Christ appear. The article continues to focus on the shape of the human-creature relationship, focusing on the current world and the social problems created by the insufficient protection of the world. The subsequent challenges come from biblical paradigms: humanity as protector, wise housekeeper and caretaker. The authors work with particular regard to the Christian paradigms, but they will also mention in passing the current models in force in Judaism and Islam. © 2020, Slovenska Vzdelavacia Obstaravacia. All rights reserved

Possible use of adaptation to hypoxia in Alzheimer's disease: A hypothesis

Disorders in memory and other cognitive functions in Alzheimer's disease (AD) may result from an exhaustion of adaptive reserves in the brain. Therefore it is a challenge to find methods to increase the adaptive reserve of the organism to combat AD. Excitotoxicity, Ca2+ homeostasis disruptions, oxidative stress, disturbed synthesis of NO, and impaired cerebral circulation are suggested as key pathogenic factors of AD. At present it appears that stimulation of the self-defense systems in neural cells is a promising strategy in restricting the progression of AD. These systems include those of antioxidants, heat shock proteins (HSPs), NO, and other so-called stress-limiting systems. Non-drug activation of these systems can be achieved most efficiently by adaptation of the organism to environmental challenges, such as hypoxia. In this paper the potential of methods used in adaptive medicine is explored. The protective mechanisms of adaptation to hypoxia may be related to restriction of oxidative stress in the hippocampus, the limitation of a decrease in NO production induced by β-amyloid, and increased density of the vascular network in the brain. In this review we selectively present data that support the idea that adaptation to hypoxia is a possible non-drug means in the prevention of AD. In our opinion this strategy may provide a break-through in the clinical approach of this disease. © Med Sci Monit, 2005