Sight Disorders Research Articles

Noninvasive Intracranial Pressure Assessment in Patients with Suspected Idiopathic Intracranial Hypertension.

Idiopathic intracranial hypertension (IIH) usually occurs in obese women of childbearing age. Typical symptoms are headache and sight disorders. Besides ophthalmoscopy, lumbar puncture is used for both diagnosis and therapy of IIH. In this study, noninvasively-assessed intracranial pressure (nICP) was compared to lumbar pressure (LP) to clarify its suitability for diagnosis of IIH. nICP was calculated using continuous signals of arterial blood pressure and cerebral blood flow velocity, a method previously introduced by the authors. In thirteen patients (f=11, m=2; age: 36±10years), nICP was assessed 1h prior to LP. If LP was >20cmH2O (~15mmHg), lumbar drainage was performed, LP was measured again, and nICP was reassessed. In six patients, LP and nICP were compared after lumbar drainage. In three patients, assessment of nICP versus LP was repeated. In total, LP and nICP correlated with R=0.82 (p<0.001; N=22). Mean difference of ICP-nICP was 0.8±3.7mmHg. Presuming 15mmHg as critical threshold for indication of lumbar drainage in 20 of 22 cases, the clinical implications would have been the same in both methods. TCD-based ICP assessment seems to be a promising method for pre-diagnosis of increased LP and might prevent the need for lumbar puncture if nICP is low.

The Role of Hypertension and Dyslipidaemia in the Progression of Diabetic Retinopathy in Type 2 Diabetes

Despite the introduction of retinal laser photocoagulation and vitreoretinal surgery, diabetic retinopathy (DR) remains a significant source of sight disorders and blindness amongst individuals with Type 2 Diabetes Mellitus (T2DM) [1]. Visual impairment and blindness can add an additional burden to individuals with T2DM, thereby, affecting their quality of life and ability to self-manage their diabetes [2]. The number of people registered blind and those with moderate to severe sight complications due to DR rose from 0.2 million to 0.4 and 1.4 million to 2.6 million respectively between 1990 to 2015 [3].

Simultaneous determination of water- and fat-soluble vitamins, lycopene and beta-carotene in tomato samples and pharmaceutical formulations: Double injection single run by reverse-phase liquid chromatography with UV detection

Vitamins and carotenes represent important dietary components essential for health, because of their potential ability to decrease the risk for heart disease, cancer and sight disorders. Established chromatographic methods are typically designed for classes of water- or fat-soluble compounds, based on their different solubility and chemical structures. The simultaneous determination of both kinds of vitamins, in addition to highly lipophilic compounds, such as carotenes, increases the complexity of an analytical method, as well as the choice of proper solubilisation solvents, which must be in tune with the chromatographic eluents.In this study, a novel LC method coupled with UV detection is described for the simultaneous determination of thiamine, riboflavin, niacin, pyridoxine, folic acid, ascorbic acid, retinol, γ-tocopherol, phylloquinone, lycopene and β-carotene. An on-line focusing step was required for column head trapping of carotenes and fat-soluble vitamins, before injecting the water-soluble vitamins. Then, two consecutive injections, combined in a single run based on a ternary gradient program, allowed an efficient separation of both lipophilic and hydrophilic compounds.The method was validated in terms of linearity, recovery and precision. Detection and quantification limits were in the range 0.6–200 μg/L and 2–700 μg/L, respectively. Finally, the potential of the proposed method was confirmed by the analysis of tomatoes and pharmaceutical formulations.

Orthodontic Aspects on the Chronological and Dental Age in Children with Down Syndrome

Genetics is a key discipline in medicine, but also a clinical discipline with medical and social implications. The interest in reducing the number of genetic disorders and recognizing the risk of them repeating when a family confronts itself with a genetic anomaly becomes more and more important in the hierarchy of prophylactic emergencies. Presenting themselves as metabolic diseases (monogenic mutations) or malformations (polygenic and multifactorial heredity) because of their frequency, these disorders position themselves on an ascendant curve. They become difficult to deal with for the society, for the family and for the interested individual and cause emotional disorders. The Down syndrome is the most frequent type of genetic disorder. It is characterized by a specific set of signs and symptoms. People with Down syndrome require special medical care that, apart from the family, must include a team of doctors of various specializations and also a dentist. They are predisposed to hearing and sight disorders and thyroid problems as well. In 50% of the cases there are also anomalies of the heart, and the risk of leukaemia is 20 times higher. Some of them even develop an Alzheimer type dementia during their life. The people with Down syndrome can have an average IQ up to a moderate form of handicap. In particular, the studies on Down syndrome in dentistry are quite frequent, but they focus more on cavities, periodontal disease and hypodontia. In spite of this, the connection of Down syndrome and dental eruption is less studied. Consequently, the present study is intended to fill this missing part from the specialized literature, focusing on the relation between the Down syndrome and the chronological and dental ages in children. The health of the oral cavity is neglected in these patients, their parents focusing more on the treatment of the other systemic disorders of their children; the lack of interest is reflected in their poor oral hygiene.The trial group included 94 children with mixt dentition, aged between 6 and 12, divided as follows: 36 children with Down syndrome enrolled at the Educational Centre for Inclusive Education no. 1 of Tg. Mures and Alpha Transilvana Foundation. The chronology and the eruption sequences are subjected to certain variations and they are influenced by the presence of cavities, the premature loss or, on the contrary, the prolonged retention of deciduous teeth as well as dental anchylosis. Dental maturation is less subjected to variations, as it is a progressive, continuous and cumulative process. The presence of Down syndrome in children generates a delay in teeth eruption by 1.27 years compared to the data identified in the specialized literature and to the information obtained on the healthy children included in the study.

Trzyipółletni chłopiec z malformacją Chiariego typu I – opis przypadku

Chiari malformation is the most common structural defect of the posterior fossa and cerebellum, consisting of displacements of hindbrain inclination through the foramen magnum, often associated with syringomyelia. In the most common type I of this disease, only the cerebellar tonsils are descended. Chiari type I malformation may remain asymptomatic in early childhood, however a number of unspecific symptoms, such as: neck pains and headaches, vertigos, balance and sight disorders, may strengthen with age. Because of unspecificity and various exacerbation of symptoms the disease is often misdiagnosed or undiagnosed. We describe a case of a 3.5-year old boy with whom his mother visited a pediatrician because of a chronic cough. During the examination mother of the patient informed that all infections start with vomiting and the patient is not able to stand up from horizontal position without turning first to the side and then to the abdomen. During the examination, a large head circumference was noticed (56 cm, &gt; 97 percentile). MRI showed elongated cerebellar tonsils descended below the foramen magnum (left 14 mm, right 11 mm). Chiari malformation type I with associated syringomyelia was diagnosed. The patient was reffered to neurosurgery consultation.

Torbiele szyszynki jako przyczyna objawów klinicznych z ośrodkowego układu nerwowego

IntroductionNonneoplasmatic pineal cyst changes are quite often found during brain MRI of pediatric patients. Usually, they are asymptomatic; however, clinical signs such as headache, sight disorders, dizziness or hydrocephalia may occur. ObjectiveEpidemiological and clinical evaluation of the occurrence of pineal cysts in children treated in a single oncological ward over a period of 7 years. MethodsRetrospective analysis of the patients hospitalized in the Department of Pediatrics, Hematology and Oncology in Bydgoszcz and diagnosed for pineal cyst by MRI. ResultsThe incidence of pineal cysts in patients who underwent MRI for various reasons was 5.2%. In 52% of the patients, MRI examination was performed to check their reported headache. The size of the cysts in MRI varied from 3mm to 21mm. Control MRI was performed in 64% of the children after 1–12 months. In 2 of them, little reduction of the size of the cyst was observed; in one case, slight enlargement was observed, and in the remaining, the size was stable. None of the patients required neurosurgical intervention. ConclusionsPineal cysts were diagnosed in 5.2% of the children with central nervous system disorder symptoms. In half of the cases, headache was the reason for starting the diagnostic procedures. Size of the pineal cysts observed in the population of pediatric patients usually does not exceed 10mm. Most of the pineal cysts have mild clinical character but always require excluding the presence of malignant process. No clinical progression was observed within 6–12 month observation in any of the patients.

The Influence of Computer Games on Children's Development. Exploratory Study on the Attitudes of Parents

The current study aims to investigate the attitudes of parents (N=1087) regarding the influence of computer games on their children's development in the following aspects: time they spend at the computer to play, types of favourite games, ways of child supervision, benefits and disadvantages of computer games. The results of the research show: 30.47% of children may access the computer anytime they want; the computer is mostly used for games (36.28%); 42.87% of parents supervise their children's activities at the computer only when they have spare time; 50% of parents allow their children to spend 1-2hours at computer games every day, while 28.54% allow 3-4hours (and more) of computer games every day.The biggest benefits of computer games, according to parents, are thinking development (9.60%), observation capacity (8.27%), and creativity (8.01%). The biggest disadvantages of computer games are the lack of physical movement (13.37%), sight disorders (13.15%) and agitation (8.58%). Parents recognize that games can have powerful effects on children, and should therefore set limits on the amount and content of games their children play. In this way, we can realize the potential benefits while minimizing the potential harms.

EPA-1195 – Peculiarities of revealing the suicidal tendencies in adolescents with disabilities

Suicidal behavior of children and adolescents with disabilities remains little studied. Adolescents with disabilities belong to risk group of development of suicidal behavior (Merrick J., Merrick E., et al., 2006; Ludi E., Ballard E.D., et al., 2012). At present stage strategies of prevention of suicides in people with disabilities have not been developed (Friedman N.D., Shedlack K.J., 2011; Ludi E., Ballard E.D., Greenbaum R. et al., 2012). Anonymous questioning of 64 schoolchildren with sight and hearing disorders of correction boarding-schools, 12-17 years old has been conducted. Questions concerned mood, presence of suicidal thoughts and plans, presence of a person whom it is possible to share their own problems with. Children with sight disorder more often than children with hearing disorder experience negative emotions caused by awareness of their defect that might be a cause of decrease of mood, suicidal thoughts. These children draw attention by contradiction in answers of the question about presence of a nearest person (81,8%) and feeling lonely in 34,1%. Rather desired presence of a person whom it is possible to share their own problems with may be supposed. Thus, children from correction schools need for work on formation of skills of psychological resistance and social competence. Obtained data are conditioning necessity of preventive activity on revealing and preventing the suicides in children and conducting timely correction.

Pathogenesis and treatment of falls in elderly

Falls in the elderly are a public health problem. Consequences of falls are increased risk of hospitalization, which results in an increase in health care costs. It is estimated that 33% of individuals older than 65 years undergoes falls. Causes of falls can be distinguished in intrinsic and extrinsic predisposing conditions. The intrinsic causes can be divided into age-related physiological changes and pathological predisposing conditions. The age-related physiological changes are sight disorders, hearing disorders, alterations in the Central Nervous System, balance deficits, musculoskeletal alterations. The pathological conditions can be Neurological, Cardiovascular, Endocrine, Psychiatric, Iatrogenic. Extrinsic causes of falling are environmental factors such as obstacles, inadequate footwear. The treatment of falls must be multidimensional and multidisciplinary. The best instrument in evaluating elderly at risk is Comprehensive Geriatric Assessment (CGA). CGA allows better management resulting in reduced costs. The treatment should be primarily preventive acting on extrinsic causes; then treatment of chronic and acute diseases. Rehabilitation is fundamental, in order to improve residual capacity, motor skills, postural control, recovery of strength. There are two main types of exercises: aerobic and muscular strength training. Education of patient is a key-point, in particular through the Back School. In conclusion falls in the elderly are presented as a "geriatric syndrome"; through a multidimensional assessment, an integrated treatment and a rehabilitation program is possible to improve quality of life in elderly.

Treatment and prevention of postoperative complications in hip fracture patients: infections and delirium

The course of older patients with hip fractures is often complicated by infections and delirium. Accurate care and high suspicion for these complications are essential, since these conditions are associated with an increase in mortality, length of hospital stay and nursing home placement, poorer mobility, and functional decline. Because of immunosenescence and higher infection rates, older patients need specific care, immediate diagnosis, and treatment of infections. Numerous guidelines of various medical societies outline the management of nosocomial infections, but there is a need of an individualized treatment plan because of comorbidities and polypharmacy. Hygiene measures have first priority to reduce the rate of infections. Treatment of geriatric syndromes like malnutrition, exsiccosis, gait disorders, falls, delirium, urine incontinence, and organ insufficiency are as important as immunization against pneumococci and influenza. Advanced age, cognitive impairment, hearing loss, peripheral vascular disease, prior delirium episodes, sight disorders, and polypharmacy are established risk factors for delirium; thus, older people with several chronic diseases are prone to delirium. A multifactorial approach, comprising standardized screening, oxygen support, intravenous fluid administration and augmented nutrition, monitoring of vital signs, pain treatment, optimized medication, and modification in perioperative management, significantly reduces delirium incidence during hospitalization for hip fracture. An interdisciplinary approach between surgeons and geriatricians may warrant optimized satisfaction of patients' needs.

FINITE ELEMENT MODELS FOR COMPUTER SIMULATION OF INTRASTROMAL PHOTOREFRACTIVE KERATECTOMY

The main idea to correct sight disorders using lasers is to modify corneal curvature by applying laser to specific layers of the cornea. Intrastromal photorefractive keratectomy (ISPRK) is a laser technique used to correct sight disorders by evaporating corneal tissue from the stroma. Evaporating such tissue produces small cavities that may coincide to form a larger cavity. The composed big cavity is assumed to collapse to deform the overall curvature of the cornea. In this work, we provide finite element models to simulate the ISRPK procedure using a three-dimensional (3D) model of the cornea with typical parameters. The model outcome was compared with an earlier 2D model used for the same purpose, so as to determine its accuracy. In addition, a 3D finite element simulation of the procedure was made for a virtual astigmatic case to visualize the corneal curvature change. The results of this work show that this finite element models provide an accurate simulation of the corneal deformation expected after performing the procedure.

A low cost adaptive graphical user interface for the visually handicapped with multiple conditions

Limited trials have been demonstrated that a Graphical User Interface (GUI) for the visually handicapped called Dynamic Pattern System (DPS) can adaptively utilize residual vision by generating different patterns, colors and shapes. Low vision simulators, used by normally sighted, have allowed researchers to clearly identify visual impairments that can be helped by DPS. However, it is not uncommon for the visually handicapped to suffer from multiple conditions having a multiplicative degenerative effect on their sight. This paper demonstrates how DPS can be used to assist individuals with compound sight disorders.

Diagnóstico das condições de saúde bucal em portadores de paralisia cerebral do município de Pelotas, Rio Grande do Sul, Brasil

Cerebral Palsy (CP) is an encephalic static lesion defined as a non-progressive disorder of movements and posture. It is usually associated with epilepsy, speaking, hearing and sight disorders and also mental retardation. Even though, people who have CP need special care for the prevention of factors linked to oral problems, in the odontological context, the literary information is contradictory when it comes to the incidence of oral diseases on patients who have cerebral palsy. In order to determine the oral health and associated factors conditions, an epidemiological research has been made in 41 children who have cerebral palsy. The variables taken into account were: social-economical aspects, risk factors for the development of oral diseases, access to odontological care, caries index, periodontal disease, malocclusion and dental fluorose. Children who were examined showed a higher level of gingivitis and caries experience, mainly on the primary dentition, and also severe malocclusions, factors that indicate the need of early intervention, whether with educational programs or healing assistance. The study has shown that, in addition to the quantitative necessity of care, it is also necessary to improve the quality of these patients' consultations.

Incidence and main factors associated with early unplanned hospital readmission among French medical inpatients aged 75 and over admitted through emergency units

among elderly patients, readmission in the month following hospital discharge is a frequent occurrence which involves a risk of functional decline, particularly among frail subjects. While previous studies have identified risk factors of early readmission, geriatric syndromes, as markers of frailty have not been assessed as potential predictors. to evaluate the risk of early unplanned readmission, and to identify predictors in inpatients aged 75 and over, admitted to medical wards through emergency departments. prospective multi-centre study. nine French hospitals. one thousand three hundred and six medical inpatients, aged 75 and older admitted through emergency departments (SAFES cohort). using logistic regressions, factors associated with early unplanned re-hospitalisation (defined as first unplanned readmission in the thirty days after discharge) were identified using data from the first week of hospital index stay obtained by comprehensive geriatric assessment. data from a thousand out of 1,306 inpatients were analysed. Early unplanned readmission occurred in 14.2% of inpatients and was not related with sociodemographic characteristics, comorbidity burden or cognitive impairment. Pressure sores (OR = 2.05, 95% CI = 1.0-3.9), poor overall condition (OR = 2.01, 95% CI = 1.3-3.0), recent loss of ability for self-feeding (OR = 1.9, 95% CI = 1.2-2.9), prior hospitalisation during the last 3 months (OR = 1.6, 95% CI = 1.1-2.5) were found to be risk factors, while sight disorders appeared as negatively associated (OR = 0.5, 95% CI = 0.3--0.8). markers of frailty (poor overall condition, pressure sores, prior hospitalisation) or severe disability (for self-feeding) were the most important predictors of early readmission among elderly medical inpatients. Early identification could facilitate preventive strategies in risk group.

Maternal contingency and the socialization of emotions in early infancy

The current study aims to investigate the attitudes of parents (N=1087) regarding the influence of computer games on their children's development in the following aspects: time they spend at the computer to play, types of favourite games, ways of child supervision, benefits and disadvantages of computer games. The results of the research show: 30.47% of children may access the computer anytime they want; the computer is mostly used for games (36.28%); 42.87% of parents supervise their children's activities at the computer only when they have spare time; 50% of parents allow their children to spend 1-2 hours at computer games every day, while 28.54% allow 3-4 hours (and more) of computer games every day.The biggest benefits of computer games, according to parents, are thinking development (9.60%), observation capacity (8.27%), and creativity (8.01%). The biggest disadvantages of computer games are the lack of physical movement (13.37%), sight disorders (13.15%) and agitation (8.58%). Parents recognize that games can have powerful effects on children, and should therefore set limits on the amount and content of games their children play. In this way, we can realize the potential benefits while minimizing the potential harms.