Ophthalmologic Examination of the Child

The ophthalmologic examination of the child consists of an assessment of the physiological function, anatomic eye, and visual system status. A comprehensive eye examination of the child should include history of presenting problem, patient’s and family’s medical histories, estimation of fixation and measurement of visual acuity, assessment of binocular vision, Bruckner test, assessment of ocular motility, Hirschberg’s test, cover/uncover test, and assessment of anterior and posterior segments. The order of examination may vary depending on the child’s cooperation. The record of the child’s level of cooperation during the examination is of great benefit in the interpretation of the results

Intraocular Lens (IOL) Materials

In 1949, first intraocular lens (IOL) insertion after cataract surgery was performed by Sir Harold Ridley, in London. Only in the 1970s, the IOL insertion after cataract surgery began to be a standard procedure. The material the first IOL-s were composed of was polymethyl methacrylate (PMMA). The PMMA is a rigid material and the corneal incision had to be at least as big as the IOLs optic and it became its biggest disadvantage in the cataract surgery. The main goal of modern cataract surgery is as smallest incision possible, so the IOL-s had to be flexible and therefore foldable. This goal was achieved by improvements in the IOL design and materials that made them foldable. First foldable IOL-s were made of hydrogel but they were unstable and the development of the first silicone IOL-s overcame that problem. Foldable silicone IOL-s were first implanted in 1978 by Kai-yi Zhou. Foldable IOL’s benefits are its compatibility with a small incision surgery that is self-sealing procedure and the possibility of insertion by a single-use applicators that made the surgery safer. In the future, we can expect some new, different and innovative approaches in the IOL design and materials

COVID-19 Conjunctivitis

The outbreak of new Cov-2 epidemic was detected in December 2019 in the city of Wuhan, China, caused by Severe Acute Respiratory Syndrome Coronavirus −2 and started its rapid spread througth the world. The World Health Organisation (WHO) declared a public health emergency of international concern (PHEIC) on the 30th of January 2020. -2 infection can present with spectrum of clinical manifestations, primary of upper respiratory tract and in some cases, especially in immunocompromised patients can cause changes in lower respiratory tract such as pneumonia and bronchitis. Conjunctivitis is not a common manifestation of SARS-Cov-2 infection. It should however be kept in mind that patients with ocular manifestations and symptoms can represent the COVID-19 cases. CoVs can produce several ocular manifestations from conjunctivitis, uveitis – anterior and posterior, retinitis and optic neuritis

Sestrinske dijagnoze u zdravstvenoj njezi umirućih bolesnika Nursing diagnosis in healthcare of dying patient

Jedinstvena stručna terminologija i klasifikacija sestrinskih dijagnoza uvjet je za kvalitetno provođenje zdravstvene njege. Usvajanjem procesa zdravstvene njege kao sustavnog i logičnog pristupa u dijagnosticiranju i rješavanju problema umirućih bolesnika sestrinske dijagnoze postale su bitan dio svakodnevne sestrinske prakse. Povijesno definiranje uloge medicinske sestre kao „njegovateljice bolesnika“ znači različitost uloge medicinske sestre u prevenciji (promocija zdravlja) te u kliničkoj strukovnosti pri sprečavanju komplikacija tijekom liječenja bolesnika u posljednjim danima života. Teorije zdravstvene njege nastale su uporabom specifičnog obrazovanja, stavova, iskustva i radnog okruženja medicinskih sestara koje su postupke implementirale u svakodnevnu praksu i zajedničku skrb za umiruće bolesnike. Danas, uporabom recentnih metoda/postupaka i prihvaćenosti procesa zdravstvene njege, medicinske sestre procjenjuju potrebe umirućih bolesnika, verificiraju probleme i prilagođavaju intervencije koje poboljšavaju stupanj kvalitete zdravstvene njege

Učinci simvastatina i fenofibrata na malondialdehid i reducirani glutation u plazmi, jetri i mozgu normolipidemičnih i hiperlipidemičnih štakora

The objective of study was to investigate the effects of different doses of simvastatin and fenofibrate on malondialdehyde (MDA) and reduced glutathione (GSH) in the plasma, liver, and brain tissue of male normolipidaemic and hyperlipidaemic rats. Normolipidaemic (Wistar) rats were receiving 10 or 50 mg/kg a day of simvastatin or 30 or 50 mg/kg a day of fenofibrate. Hyperlipidaemic (Zucker) rats were receiving 50 mg/kg/day of simvastatin or 30 mg/kg/day of fenofibrate. Control normolipidaemic and hyperlipidaemic rats were receiving saline. Simvastatin, fenofibrate, and saline were administered by gavage for three weeks. In normolipidaemic rats simvastatin and fenofibrate showed similar and dose-independent effects on plasma and brain MDA and GSH concentrations. Generally, plasma and brain MDA decreased, while brain GSH concentration increased. In hyperlipidaemic rats simvastatin did not affect plasma and brain MDA and GSH concentrations but significantly decreased liver GSH. Fenofibrate decreased plasma and liver MDA but increased brain MDA. In both rat strains fenofibrate significantly decreased liver GSH concentrations, most likely because fenofibrate metabolites bind to GSH. Our findings suggest that simvastatin acts as an antioxidant only in normolipidaemic rats, whereas fenofibrate acts as an antioxidant in both rat strains.Cilj ovog istraživanja bio je istražiti učinke različitih doza simvastatina i fenofibrata na malondialdehid (MDA) i reducirani glutation (GSH) u plazmi, jetri i mozgu mužjaka normolipidemičnih (Wistar) i hiperlipidemičnih (Zucker) štakora. Na prvim dvjema eksperimentalnim skupinama normolipidemičnih štakora simvastatin je primijenjen u dozama 10 ili 50 mg/kg dnevno, a fenofibrat na trećoj i četvrtoj skupini u dozama od 30 i 50 mg/kg/dan. Prva eksperimentalna skupina hiperlipidemičnih štakora primala je simvastatin 50 mg/kg/dan, a druga fenofibrat 30 mg/kg/dan. Kontrolne skupine normolipidemičnih i hiperlipidemičnih štakora primale su fiziološku otopinu. Simvastatin, fenofibrat i fiziološka otopina primjenjivani su oralno tijekom tri tjedna. U plazmi i mozgu normolipidemičnih štakora simvastatin I fenofibrat pokazali su slične i o dozi neovisne učinke na koncentracije MDA i GSH. Općenito, MDA je bio smanjen, a koncentracija GSH bila je povećana. U hiperlipidemičnih štakora simvastatin nije utjecao na koncentraciju MDA i GSH, ali je prouzročio značajno smanjenje GSH u jetri. Fenofibrat je smanjio MDA u plazmi i jetri te povećao MDA u mozgu. U oba soja štakora fenofibrat je značajno smanjio koncentraciju GSH u jetri, vjerojatno zbog konjugacije GSH s nekim metabolitima fenofibrata. Prema našim rezultatima, simvastatin djeluje antioksidacijski samo u normolipidemičnih štakora, a antioksidacijski učinak fenofibrata prisutan je u oba soja

Assessing literature of Vitamin D and diabetic retinopathy

Background: Vitamin D plays an important role in a variety of biological functions.1 Numerous studies demonstrating that adequate vitamin D levels are important in eye homeostasis.2 There is increasing evidence of the association between eye diseases and vitamin D in literature. Aim: To evaluate scientometric data of Vitamin D and diabetic retinopathy. Methods: We analyzed the number of publications of Vitamin D and diabetic retinopathy as key words at Web of Sciences with advanced search using TS=(Vitamin D and diabetic retinopathy) from 1955 to 2019. Hypotheses: There is still a lack of important clinical studies on the role of vitamin D in diabetic retinopathy. Results: We retrieved a total of 114 articles published in the Clinical Medicine and Life Sciences section. The h-index of these publications was 25, an average citation per item was 20.46, the sum of times cited was 2.332. There were 1.864 citing articles. The number of citations significantly increased from 2002 to 2018, with the highest rate in 2017 (308 articles). The article with the highest number of citations had a total of 296 citations. The highest number of articles 48 (42.105%) was published in the field of endocrinology metabolism. Out of 114 articles, 91 were original scientific articles (79.825%), there were 13 reviews (11.404%), 10 meeting abstract (8.772%) and one book chapter (0.877%). Conclusions: Although the number of articles on Vitamin D and diabetic retinopathy is increasing every year, it is still insufficient to establish the role of vitamin D in diabetic retinopathy

The role of the Mediterranean diet in age macular degeneration

A Mediterranean diet is based on the traditional foods that people used to eat in the countries on the Mediterranean Sea. It is based on eating less meat and more fish, vegetables, fruit, legumes, unrefined grains, and olive oil. A Mediterranean diet is the “Prototype” of a healthy diet! Previous research has linked a Mediterranean diet with a reduced incidence of heart disease, strokes, type 2 diabetes, premature death and cognitive decline. Only a few studies have evaluated its impact on age related macular degeneration (AMD). Some studies showed it can be helpful with certain types of age related macular degeneration, and at different stages of the disease. Age related macular degeneration is a degenerative eye disease. It causes loss of central vision, which is crucial for simple everyday activities, such as the ability to see faces, drive, read, and write. It is a leading cause of vision loss among people age 50 and older, affecting 1.8 million Americans. That number is expected to be nearly 3 million by 2020. Aim: To evaluate the potential protective role of a Mediterranean diet in age related macular degeneration Methods: We analyzed the publications at Web of Sciences with advanced search using TS = published in from year 1955 to 2019. Hypotheses: A Mediterranean diet reduces the risk of early development of age related macular degeneration and reduces the risk of progression to advanced forms of the disease. Results: We analyzed 31 articles published in the Clinical Medicine and Life Sciences section. The h-index of these publications was 8, an average citation per item was 13.68, and the sum of times cited was 424. There were 399 citing articles. The number of articles significantly increased from 2000 to 2019, with the highest rate in 2018 (10 articles). The article with the highest number of citations had a total of 69 citations. The highest number of articles 12 (38.709%) was published in the field ophthalmology. Out of 31 articles, 18 were original scientific articles (58.065%), 6 were reviews (19.355%), 3 meeting abstract (9.677%), editorial material 2 (6.452), one correction (3.226), and one proceedings paper (3.226 %). Conclusion: Higher adherence to the Mediterranean diet is associated with the protective effect in AMD development and progressio

RELIGIOUSNESS, ANXIETY AND DEPRESSION IN PATIENTS WITH GLAUCOMA, AGE-RELATED MACULAR DEGENERATION AND DIABETIC RETINOPATHY

Background: Many chronic medical conditions such as glaucoma, senile macular degeneration and diabetic retinopathy are further complicated by emotional and psychological disorders. Religiousness represents a part of a social culture and has a significant role in the prevention of mental difficulties of the patients, especially those belonging to older population. The aim of this study was to investigate the connection between religiousness, anxiety, and depression in patients with glaucoma, age-related macular degeneration and diabetic retinopathy and to test their connection related to different diagnosis. Subjects and methods: This cross-sectional study included 163 patients divided into three groups (glaucoma group, senile macular degeneration group and diabetic retinopathy group). Respondents voluntarily agreed to participate in the study and with assistance they fully completed the Scale of Religiousness, Hospital Anxiety and Depression Scale, General Health Questionnaire and demographic information (age, gender, education, employment and marital status). Results: The results showed noticeable religiosity of the respondents (M=18.31, SD=5.28), but also the presence of anxiety (M=7.55, SD=3.73), especially in patients with glaucoma, as well as impaired mental health in AMD patients (M=19.56, SD=4.14). No differences were found in the severity of anxiety, depression, general health and religiosity between groups, but the presence of depression in subjects with age-related macular degeneration significantly affects the level of religiosity (p=0.032). Conclusion: These results unequivocally point to the need for further research and raising awareness of all health professionals about the importance of a holistic approach to the patient regardless of his diagnosis in order to identify the possible effective ways to deal with chronic disease considering all levels of patient\u27s needs

Prevalencija humanog papiloma virusa kod karcinoma larinksa, orofarinksa i usne šupljine u Zadarskoj županiji

We present a retrospective research of HPV testing of tissue samples, by the polymerase chain reaction method (PCR), in patients that underwent surgery due to squamous cell carcinoma of the oral cavity, oropharynx or larynx in Zadar General Hospital in the period from 2007 to 2016. Out of 99 patients included in this study, 89 (89,9%) were men with median age of 62.3 years and ten (10,1 %) were women with median age of 66 years. According to the cancer site, the percentage of HPV positive carcinoma tissue samples of larynx carcinoma, oral cavity carcinoma and oropharyngeal carcinoma were 25.8%, 26.9% and 18,2 %, respectively. According to the HPV genotype, among all cancer sites, in 60% (n=15) HPV 16 were detected, and in 40% mixed HPV infection, that is, in 32% (n=8) HPV 16, 26, 34, 53 and in 8% (n=2) HPV 16, 18, 26, 34, 53. The presented research results support the need for stronger public health promotion of vaccines against HPV, and the selection of the best strategy for the implementation of vaccination to prevent cancer of the larynx, oropharynx and oral cavity among men.Radi se o retrospektivnom istraživanju HPV testiranja metodom lančane reakcije polimeraze (PCR) uzoraka tkiva pacijenata operiranih zbog karcinoma skvamoznih stanica usne šupljine, orofarinksa ili grkljana u Općoj bolnici Zadar u razdoblju od 2007. do 2016. godine. Od 99 pacijenata uključenih u ovu studiju, 89 (89,9%) bili su muškarci s medijanom dobi od 62,3 godine i 10 (10,1%) su bile žene s medijanom dobi od 66 godina. Ukupno je u 25 (25,3%) uzoraka tkiva bolesnika otkrivena prisutnost HPV DNA. Prema mjestu raka, postotak uzoraka HPV pozitivnih karcinoma tkiva, karcinoma grkljana, karcinoma usne šupljine i karcinoma orofaringeusa bio je 25,8%, 26,9% odnosno 18,2%. Prema genotipu HPV-a, od svih sijela karcinoma, u 60% (n=15) otkriven je HPV 16, a u 40% mješovite HPV infekcije, i to u 32% (n=8) HPV 16, 26, 34, 53 te u 8% (n=2) HPV 16, 18, 26, 34, 53. Predstavljeni rezultati istraživanja podupiru potrebu jače javnozdravstvene promocije cjepiva protiv HPV-a, te odabir najbolje strategije za provedbu cijepljenja za prevenciju raka grkljana, orofarinksa i usne šupljine kod muškaraca