Vol 28, No 2 (2022)

BACKGROUND: In the last decade, the number of randomized controlled trials indicating the safety and efficacy of immediate sequential bilateral cataract surgery (ISBCS) comparable to the results of delayed sequential bilateral cataract surgery (DSBCS) has been increasing. However, these studies are practically absent in the practice of domestic ophthalmology.

AIM: To comparatively assess the clinical results of ISBCS and DSBCS.

METHODS: Our observation revealed that 1000 patients (2000 eyes) with binocular cataracts aged 37–68 years (mean age: 56.9±1.3 years), including 82% of males and 18% of females. Patients were divided into two groups: the main group (500 patients, 1000 eyes), who underwent ISBCS according to the developed modified algorithm (ma ISBCS), and the control group (500 patients, 1000 eyes), who underwent DSBCS technology with a break after the first surgical intervention 7–10 days. The study was conducted from January 2017 to September 2021. All patients were operated on by one surgeon. The following monofocal intraocular lenses (IOLs) were implanted to correct aphakia: Acrysof Natural IQ (Alcon, USA), Akreos AO (Bausch & Lomb, USA), and Biflex (Medicontur, Hungary). Biometrics and IOL calculation were performed using an optical biometer IOL Master (Zeiss, Germany). The following clinical efficacy criteria were assessed (before and 3 months postoperatively): the presence of intra- and postoperative complications, measurement of the maximum correctable distance visual acuity (BCVA), and deviation from the target (±0.5 D) refraction.

RESULTS: maISBCS provides almost identical (with DSBCS) clinical results of surgical intervention, which is confirmed by the minimum (0.1%–0.6%, n=1000) level of postoperative complications (in the absence of endophthalmitis), the average values of BCVA (0.94±0.02; 0.95±0.02, p=0.724) and «target» refraction (0.30±0.05; 0.28±0.04, p=0.723), achieving BCVA of 1.0 rel unit (87%–88% of cases), and emmetropic refraction (28%–29% of cases).

CONCLUSION: maISBCS is a promising direction in cataract surgery, especially considering the established (compared to DSBCS) advantages associated with higher efficiency in terms of anisometropia development and the priority of performing in a difficult epidemiological environment, as well as a significant reduction in the financial costs of surgery.

BACKGROUND: Dental implant stability depends on the mechanical bone properties in the area of the planned surgical intervention and the correctness of the implant embedded in the bone tissue. A significantly decreased bone tissue mineral density of the jaws was found in patients with osteoporosis, which complicates or even prevents the restoration of the integrity of the dentition by the dental implantation method.

AIM: This study aimed to conduct a comparative assessment of the effectiveness of the treatment of dentition defects by dental implantation in patients with a normal state of bone tissue, osteopenia, and osteoporosis, to assess the stability of the installed implants using the resonance frequency analysis.

MATERIALS AND METHODS: All patients underwent a densitometric study using double X-ray photon absorptiometry, in addition to the basic examination, in dental implantation operation preparation, which made it possible to identify systemic and regional changes in bone mineral density. Dental implant stability and osseointegration were controlled by the resonant frequency analysis method.

RESULTS: The parameters of resonance frequency analysis in patients with normal bone mass, osteopenia, and osteoporosis vary depending on the area where the implants are installed when studying the implant stability in patients with different bone mineral densities. The overall index of resonance frequency analysis values differed from those of the group with osteopenia and osteoporosis, regardless of the area of implants installed in patients with normal bone tissue, and was respectively higher by 7.1% (p <0.001) and 10.1% (p <0.001), respectively. The overall index in the group with osteopenia was higher and differed from that in the group with osteoporosis by 5.7% (p <0.001).

CONCLUSION: The resonance frequency analysis results provide significant information about the state of the implant-bone interface at different treatment stages and during follow-up examinations of patients. The measurement technique makes it possible to observe the dynamics of the osseointegration process, and, if necessary, make timely adjustments to the functional load. Resonance frequency analysis is an important method for documenting the clinical outcome of implantation. This is of particular importance from a medical-legal point of view.

The problem of providing rehabilitation assistance to the population has been repeatedly discussed in the global community. One of the important events in recent years was the meeting of participants in «Rehabilitation 2030: Call to Action», where the problem of increasing dissatisfaction in rehabilitation services worldwide, especially in low- and middle-income countries, was discussed. The upward trend in the need for rehabilitation activities will increase in line with global trends in demographic change associated with the aging population and an increase in the number of people living with sequellae of diseases and injuries. The prevalence of health conditions associated with severe functional limitations, of which many are caused by non-communicable diseases, increased by 9.9% and affected almost 14 million people from 2006 to 2016 in the World Health Organization European Region. Devices for monitoring vital signs can become one of the potentially important components of effective rehabilitation with an increased number of technical means of rehabilitation. The constant transfer of these parameters to the cloud storage, followed by machine learning algorithm processing, will determine the prescribed drug therapy efficiency and determine the need for timely hospitalization for a medical organization. This study aimed to assess the needs of patients with a chronic consciousness impairment, and relatives caring for them, using the possibilities of remote monitoring. The study showed that the use of hospital-replacing outpatient equipment that records the vital signs of patients opens up new opportunities for consolidating the information into a big data archive to assess the treatment efficiency and the characteristics of patient rehabilitation with the implementation of the most optimal measures to influence the rehabilitation process approach.

Stress-induced cardiomyopathy, also known as takotsubo cardiomyopathy (TCM), is a type of reversible left ventricular dysfunction that occurs after emotional or physical stress and manifests as chest pain, electrocardiographic changes mimicking myocardial ischemia, cardiac enzyme elevation, transient left ventricular dysfunction involving mid and apical segments and normal or near-normal coronary angiography. This syndrome could happen after iatrogenic stressors like anesthesia or surgery. We hereby present two cases of TCM after anesthesia and surgery. In both cases, clinical, electrocardiographic, echocardiographic, and angiographic findings are employed to confirm this diagnosis.