723 research outputs found
Eye and Pregnancy
Hormonal, metabolic, hemodynamic, vascular and immunological changes that occur during pregnancy can affect the function of the eye. These changes are commonly transient, but in some cases they may be permanent and have consequences even after childbirth. The ocular effects of pregnancy may be physiological or pathological and can be associated with the development of new ocular pathology or may be modifications of pre-existing conditions. The most common
physiological changes are alterations of corneal sensitivity and thickness, decreased tolerance to contact lenses, decreased
intraocular pressure, hemeralopia and refractive errors. Possible posterior segment changes include worsening of diabetic retinopathy, central serous chorioretinopathy, increased risk of peripheral vitreochorioretinal dystrophies and retinal detachment. Thus, it should be kept in mind that the presence of any ocular symptoms in a pregnant woman requires ophthalmologic examination and further management
Minimalno invazivne metode u lije^enju raka dojke: pregled protokola
One can find an increasing number of articles with minimally invasive methods in current literature concerning local treatment of breast cancer. The methods can be divided in two groups: percutaneous excision methods and thermal ablation methods. Thermal ablation methods are based on the premise that malignant tissue is more sensitive to hyperthermia than normal cells.
We are comparing advantages and disadvantages of current minimally invasive methods for treatment of early stage breast cancers, showing differences and advantages over breast-conserving surgery. Available published studies and protocols are overviewed.
Most of the published works emphasize advantages over classic breast surgery such as: lower costs, less trauma for patients and smaller invasiveness. All methods involving thermal procedures require surgical excision afterwards for evaluation of necrosis and patohistological evaluation of the lesion.
The effect of these treatment methods should be safety, painlessness, good cosmetic results and lower treatment costs. If results of such methods are to be comparable to BCS, we can expect their integration in clinical practice.U suvremenom pristupu lokalnog lijeÄenja tumora dojke sve viÅ”e prostora u struÄnim publikacijama zauzimaju izvjeÅ”Äa o primjeni tzv. minimalno invazivnih metoda, meÄu kojima su dvije osnovne skupine: perkutane ekscizijske metode i termalne ablacijske metode. Temelj termalnih ablacijskih postupaka u lijeÄenju tumora dojke leži u Äinjenici da tumori pokazuju veÄu senzitivnost na hipertermiÄka oÅ”teÄenja od normalnih stanica.
U radu se nastoje komparacijom prednosti i nedostataka ovih suvremenih minimalno invazivnih metoda u lijeÄenju tumora dojke nižih stadija, utvrditi razlika i eventualna prednost tih postupaka prema poÅ”tednim kirurÅ”kim zahvatima . Pregledani su dostupni publicirani protokoli i iskustva u provoÄenju perkutanih bioptiÄkih metoda i nekih termalnih ablacijskih metoda u minimalno invazivnoj kirurgiji dojke.
U veÄini pregledanih publikacija i protokola, naglaÅ”ena je prednost opisanih metoda nad klasiÄnom kirurgijom dojke, koja je izražena u nižim troÅ”kovima, smanjenju psihiÄkih trauma lijeÄenih bolesnica i niskom razinom invazivnosti. U gotovo svim pregledanim protokolima koji se odnose na tzv. termalne metode uoÄena je potreba za naknadnom kirurÅ”kom ekscizijom radi procjene stupnja nekroze i patohistoloÅ”ke provjere lezije.
UspjeÅ”nost lijeÄenja tumora dojke ovim metodama bi se trebala temeljiti na sigurnosti, bezbolnosti, dobrim kozmetiÄkim rezultatima i nižim troÅ”kovima lijeÄenja. Ove bi metode mogle doživjeti punu primjenu u kliniÄkoj praksi ako se njima postigne rezultat ekvivalentan onome koji se postiže sa poÅ”tednim kirurÅ”kim zahvatima (BCS)
Minimalno invazivne metode u lije^enju raka dojke: pregled protokola
One can find an increasing number of articles with minimally invasive methods in current literature concerning local treatment of breast cancer. The methods can be divided in two groups: percutaneous excision methods and thermal ablation methods. Thermal ablation methods are based on the premise that malignant tissue is more sensitive to hyperthermia than normal cells.
We are comparing advantages and disadvantages of current minimally invasive methods for treatment of early stage breast cancers, showing differences and advantages over breast-conserving surgery. Available published studies and protocols are overviewed.
Most of the published works emphasize advantages over classic breast surgery such as: lower costs, less trauma for patients and smaller invasiveness. All methods involving thermal procedures require surgical excision afterwards for evaluation of necrosis and patohistological evaluation of the lesion.
The effect of these treatment methods should be safety, painlessness, good cosmetic results and lower treatment costs. If results of such methods are to be comparable to BCS, we can expect their integration in clinical practice.U suvremenom pristupu lokalnog lijeÄenja tumora dojke sve viÅ”e prostora u struÄnim publikacijama zauzimaju izvjeÅ”Äa o primjeni tzv. minimalno invazivnih metoda, meÄu kojima su dvije osnovne skupine: perkutane ekscizijske metode i termalne ablacijske metode. Temelj termalnih ablacijskih postupaka u lijeÄenju tumora dojke leži u Äinjenici da tumori pokazuju veÄu senzitivnost na hipertermiÄka oÅ”teÄenja od normalnih stanica.
U radu se nastoje komparacijom prednosti i nedostataka ovih suvremenih minimalno invazivnih metoda u lijeÄenju tumora dojke nižih stadija, utvrditi razlika i eventualna prednost tih postupaka prema poÅ”tednim kirurÅ”kim zahvatima . Pregledani su dostupni publicirani protokoli i iskustva u provoÄenju perkutanih bioptiÄkih metoda i nekih termalnih ablacijskih metoda u minimalno invazivnoj kirurgiji dojke.
U veÄini pregledanih publikacija i protokola, naglaÅ”ena je prednost opisanih metoda nad klasiÄnom kirurgijom dojke, koja je izražena u nižim troÅ”kovima, smanjenju psihiÄkih trauma lijeÄenih bolesnica i niskom razinom invazivnosti. U gotovo svim pregledanim protokolima koji se odnose na tzv. termalne metode uoÄena je potreba za naknadnom kirurÅ”kom ekscizijom radi procjene stupnja nekroze i patohistoloÅ”ke provjere lezije.
UspjeÅ”nost lijeÄenja tumora dojke ovim metodama bi se trebala temeljiti na sigurnosti, bezbolnosti, dobrim kozmetiÄkim rezultatima i nižim troÅ”kovima lijeÄenja. Ove bi metode mogle doživjeti punu primjenu u kliniÄkoj praksi ako se njima postigne rezultat ekvivalentan onome koji se postiže sa poÅ”tednim kirurÅ”kim zahvatima (BCS)
Dry Eye Symptoms and Signs in Long-Term Contact Lens Wearers
The aim of this study is to analyze the relationship between the self-reported symptoms and objective signs of dry eye disease in long-term rigid gas-permeable (RGP) or soft contact lens (SCL) wearers. The study included 32 eyes of Caucasian RGP and SCL wearers between the age of 21 and 42 who wore contact lenses continuously on a daily basis for more than 2 years. Symptoms were assessed according to the Ocular Surface Disease Index (OSDI). Clinical assessments included corneal fluorescein staining according to the National Eye Institute (NEI) staining grid, tear film break-up time
(TBUT) and Schirmer II test. There were more male (62.5%) than female (37.5%) patients with a higher proportion of RGP wearers among males (40% vs. 17%) in the study. The mean duration of daily lens wear was 10.6 Ā± 5.37 hours, with a significantly higher proportion of patients who wore their lenses for prolonged hours in the soft contact lens group (p<0.05). There was a trend towards a higher proportion of self reported mild and moderate dry eye in females and soft contact lens wearers. No RGP wearer in this study had a NEI corneal staining grid score higher than 2. A moderate negative correlation was found between daily lens wear duration and TBUT (Pearsonās coefficient, r=ā0.47) as well as Schirmer II values and higher OSDI score, i.e. mild and moderate dry eye categories (r=ā0.50). A strong positive correlation was found between and TBUT and Schirmer II values (r=0.74). The results of the study emphasize the importance of early and accurate diagnosis of dry eye disease for successful long term RGP and SCL contact lens wear which will
hopefully motivate future larger scale investigations on dry eye related problems in contact lens wearers
COMPARISON OF THE SCHEIN AND OSDI QUESTIONNAIRE AS INDICATOR OF TEAR FILM STABILITY IN PATIENTS WITH SCHIZOPHRENIA
Background: The aim of this research was to determine which of two chosen questionnaires for subjective symptoms of dry eye
(Ocular Surface Disease Index and Schein questionnaire) is more reliable in the assessment of dry eye in patients with
schizophrenia.
Subjects and methods: Our research included 80 patients (160 eyes) of both sexes with schizophrenia ranging between the age of
25 and 55 who have been taking one of three antipsychotic drugs namely clozapin, olanzapin, quetiapin for five or more years and
were in a stable phase of the disease or remission. All participants were required to satisfy all included and excluded criteria. They
all filled out the Schein and OSDI questionnaires for assessment of subjective symptoms. Tear break-up time test (TBUT) for
objective evaluation of tear film stability was also performed. In order to determine the correlation between two subjective and
objective tests we calculated Spearmans correlation coefficients.
Results: Obtained results of the correlation between OSDI questionnaire and TBUT test for the right eye was r=-0.73; p<0.01
and for the left eye was r=-0.72; p<0.01. Results of the correlation between Schein questionnaire and TBUT test for the right eye
was r=-0.62; p<0.01 and for the left eye was r=-0.60; p<0.01. A detailed analysis shows that there are no statistically significant
differences between the correlations. Both subjective questionnaires are statistically significantly and negatively related to the TBUT
test, showing that an increase in the results on the OSDI and Schein\u27s questionnaires led to the decreases in the results on the TBUT test.
Conclusion: In patients with schizophrenia the OSDI and Schein questionnaires are equally reliable in the assessment of
subjective symptoms of Dry eye disease. Considering that, OSDI is more common in clinical practice and includes questions
regarding quality of life, it would have certain advantages and it is recommended for use in patients with schizophrenia
Traumatska optiÄka neuropatija ā prikaz sluÄaja s raspravom o dijagnostiÄkim postupcima i lijeÄenju
Traumatic optic neuropathy (TON) is a serious vision threatening condition that can be caused by ocular or head trauma. Indirect damage to the optic nerve is the most common form of TON occurring in 0.5% to 5% of all closed head trauma cases. Although the degree of visual loss after indirect TON may vary, approximately 50% of all patients are left with ālight perceptionā or āno light perceptionā vision, making TON a significant cause of permanent vision loss. We present a 47-year-old male patient with a history of right eye keratoconus following a motorcycle crash. Visual acuity was of ācounting fingers at 2 metersā on the right eye due to keratoconus and ācounting fingers at 1 meterā on the left eye as a consequence of trauma. The Octopus visual field showed diffuse reduction in retinal sensitivity and the Ishihara color test indicated dysfunction of color perception on the left eye. Relative afferent pupillary defect was also present. Computed tomography revealed multifragmentary fracture of the frontal sinus and the roof of the left orbit without bone displacement. Based on the findings, conservative corticosteroid therapy without surgery was conducted. The patient responded well to treatment with complete ophthalmologic recovery.Traumatska optiÄka neuropatija (TON) može biti uzrokovana traumom oka ili glave i predstavlja ozbiljno stanje koje može ugrožavati vidnu funkciju. Indirektno oÅ”teÄenje oÄnoga živca je najÄeÅ”Äi oblik TON-a, a javlja se u 0,5% do 5% sluÄajeva svih zatvorenih trauma glave. Iako stupanj gubitka vida nakon indirektne traume vidnoga živca može varirati, u oko 50% svih bolesnika vidna oÅ”trina je smanjena na āosjeÄaj svjetlaā ili ābez osjeÄaja svjetlaā, zbog Äega TON predstavlja znaÄajan uzrok trajnog gubitka vida. Prikazan je sluÄaj 47-godiÅ”njeg bolesnika s povredom vidnoga živca nakon motociklistiÄke prometne nezgode. Vidna oÅ”trina na desnom oku bila je ābrojanje prstiju na 2 metraā, zbog otprije postojeÄeg keratokonusa i ābrojanje prstiju na 1 metarā na lijevom oku kao posljedica traume. Nalaz vidnoga polja Octopus pokazao je difuzno smanjenje osjetljivosti mrežnice, a test Ishihara za boje ukazao je na poremeÄaj osjeta boja na lijevom oku uz prisutnost relativnog aferentnog pupilarnog defekta. Kompjutorizirana tomografija pokazala je multifragmentne frakture frontalnog sinusa i krova lijeve orbite bez pomaka kostiju. Na temelju kliniÄke slike i nalaza provedeno je uspjeÅ”no konzervativno lijeÄenje kortikosteroidima s potpunim oftalmoloÅ”kim oporavkom
PSYCHIATRIC DISORDERS AND DRY EYE DISEASE - A TRANSDISCIPLINARY APPROACH
Dry eye disease (DED) is a multifactorial disorder representing one of the most common ocular morbidities and a significant
public health problem. It often results in eye discomfort, visual disturbances and potential damage to the corneal surface affecting
quality of life (QOL).
In recent years, the relationship between DED and psychiatric disorders has been gaining attention. A number of
epidemiological studies have reported a possible association between dry eye and psychiatric disorders showing that the subjective
symptoms of dry eye can be affected not only by changes of the tear film and ocular surface but also psychological factors such as
anxiety, depression, schizophrenia, post-traumatic stress disorder (PTSP) and subjective happiness. Apart from psychiatric
disorders, psychiatric medications are also considered as risk factors for DED due to their influence on the tear film status. The
incidence of ocular side effects increases rapidly with the use of polypharmacy, a very common form of treatment used in psychiatry.
There is often inconsistency between signs and symptoms of DED, where symptoms often are more related to non-ocular
conditions including psychiatric disorders than to tear film parameters. Consequently, in many cases DED may be considered as a
psychiatric as well as ophthalmological problem. Psychiatrists and ophthalmologists need to be aware of the potential influence of
psychiatric disorders and medications on tear film stability. In treatment of psychiatric patients, an integrative and transdisciplinary
approach will result in better functioning and higher QOL
Effectiveness of Latanoprost (Xalatanā¢) Monotherapy in Newly Discovered and Previously Medicamentously Treated Primary Open Angle Glaucoma Patients
We evaluated the effectiveness of latanoprost (Xalatanā¢) monotherapy in primary open angle glaucoma (POAG). Latanoprost is a prostaglandin analogue, the pure 15Ā® epimer of 13,14-dihydro-17-phenyl-18,19,20-trinor-PGF2Ī±- isopropyl ester. As a prodrug it is being activated by enzymatic hydrolysis in the cornea after which it becomes active acid of latanoprost. Latanoprost is lowering the intraocular pressure (IOP) by increasing the uveoscleral outflow. In this study, latanoprost was used once daily as monotherapy what offers much better compliance for the patients than other combinations of drugs, preserving good IOP control. Based on the significant reduction of the IOP, measured on
the day 60 of the trial (mean change in IOP was ā5.1 mmHg, with 95% confidence interval in range from ā5.6 to ā4.5), it is concluded that use of latanoprost is advisable when calculating better IOP control, few side-effects and reductions in costs of potential surgical procedures
Effectiveness of Latanoprost (Xalatanā¢) Monotherapy in Newly Discovered and Previously Medicamentously Treated Primary Open Angle Glaucoma Patients
We evaluated the effectiveness of latanoprost (Xalatanā¢) monotherapy in primary open angle glaucoma (POAG). Latanoprost is a prostaglandin analogue, the pure 15Ā® epimer of 13,14-dihydro-17-phenyl-18,19,20-trinor-PGF2Ī±- isopropyl ester. As a prodrug it is being activated by enzymatic hydrolysis in the cornea after which it becomes active acid of latanoprost. Latanoprost is lowering the intraocular pressure (IOP) by increasing the uveoscleral outflow. In this study, latanoprost was used once daily as monotherapy what offers much better compliance for the patients than other combinations of drugs, preserving good IOP control. Based on the significant reduction of the IOP, measured on
the day 60 of the trial (mean change in IOP was ā5.1 mmHg, with 95% confidence interval in range from ā5.6 to ā4.5), it is concluded that use of latanoprost is advisable when calculating better IOP control, few side-effects and reductions in costs of potential surgical procedures
Dry Eye Symptoms and Signs in Long-Term Contact Lens Wearers
The aim of this study is to analyze the relationship between the self-reported symptoms and objective signs of dry eye disease in long-term rigid gas-permeable (RGP) or soft contact lens (SCL) wearers. The study included 32 eyes of Caucasian RGP and SCL wearers between the age of 21 and 42 who wore contact lenses continuously on a daily basis for more than 2 years. Symptoms were assessed according to the Ocular Surface Disease Index (OSDI). Clinical assessments included corneal fluorescein staining according to the National Eye Institute (NEI) staining grid, tear film break-up time
(TBUT) and Schirmer II test. There were more male (62.5%) than female (37.5%) patients with a higher proportion of RGP wearers among males (40% vs. 17%) in the study. The mean duration of daily lens wear was 10.6 Ā± 5.37 hours, with a significantly higher proportion of patients who wore their lenses for prolonged hours in the soft contact lens group (p<0.05). There was a trend towards a higher proportion of self reported mild and moderate dry eye in females and soft contact lens wearers. No RGP wearer in this study had a NEI corneal staining grid score higher than 2. A moderate negative correlation was found between daily lens wear duration and TBUT (Pearsonās coefficient, r=ā0.47) as well as Schirmer II values and higher OSDI score, i.e. mild and moderate dry eye categories (r=ā0.50). A strong positive correlation was found between and TBUT and Schirmer II values (r=0.74). The results of the study emphasize the importance of early and accurate diagnosis of dry eye disease for successful long term RGP and SCL contact lens wear which will
hopefully motivate future larger scale investigations on dry eye related problems in contact lens wearers
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