Cíl: Zhodnocení výsledků bezpečnosti a účinnosti implantace PRESERFLOTM MicroShunt u pacientů s primárním glaukomem otevřeného úhlu. Soubor a metodika: Retrospektivní analýza dat 19 očí 12 pacientů, z toho 5 žen a 7 mužů. Pacienti byli operováni od srpna 2020 do února 2022. Sledovací období bylo stanoveno na 24 měsíců od operace. Ve sledovacím období byla zjišťována hodnota nitroočního tlaku (NOT), nutnost podávání lokální antiglaukomové farmakoterapie a její spektrum, stav zorného pole, nález na terči zrakového nervu a komplikace v pooperačním období. Indikací k implantaci PRESERFLOTM MicroShunt byl primární glaukom otevřeného úhlu (PGOÚ) špatně kontrolovatelný s maximální možnou tolerovanou medikací. Výsledky: Průměrný NOT byl snížen z 19,05 ±5,58 mmHg před operací, na 11,47 ±2,48 mmHg 3 měsíce po operaci, 12,26 ±2,48 mmHg 6 měsíců po operaci, 14,0 mmHg ±2,43 12 měsíců po operaci, 11,78 ±2,37 mmHg 18 měsíců po operaci a 12,73 ±2,51 mmHg 24 měsíců po operaci (p < 0,001). Bez nutnosti antiglaukomové medikace bylo 3 měsíce po operaci 19 očí, 6 měsíců po operaci 19 očí, 12 měsíců po operaci 19 očí, 18 měsíců po operaci 16 očí a 24 měsíců po operaci 15 očí. Nutnost nasazení monoterapie byla na 1 oku (5,26 %) 18 měsíců po operaci a na 2 očích (10,52 %) 24 měsíců po operaci. Nutnost nasazení dvojkombinace byla 18 měsíců po operaci na 2 očích (10,52 %) a 24 měsíců po operaci na 2 očích (10,52 %). V časném pooperačním období jsme zaznamenali uvolněný spojivkový steh na 3 očích s následnou resuturou na 1 oku. V pozdním pooperačním období jsme u jednoho oka zjistili obstrukci implantátu sklivcovým vláknem, což si vyžádalo jeho výměnu. Závěr: Z našich prvotních výsledků vyplývá, že glaukomový implantát PRESERFLOTM MicroShunt je účinnou chirurgickou metodou s minimálními pooperačními komplikacemi, vedoucí ke statisticky významnému snížení průměrného NOT a k vysazení či snížení lokální antiglaukomové medikace po dobu dvou let od operace
Aim: To evaluate the safety and efficacy outcomes of PRESERFLO™ MicroShunt implantation in patients with primary open-angle glaucoma. Material and Methods: Retrospective data analysis of 19 eyes of 12 patients, comprising 5 females and 7 males. The patients underwent surgery between August 2020 and February 2022. The follow-up period was 24 months after surgery. During the follow-up period, intraocular pressure (IOP), the need to apply topical antiglaucoma medication and its spectrum, visual field status, optic nerve target findings and postoperative complications were recorded. The indication for PRESERFLO™ MicroShunt implantation was primary open angle glaucoma (POAG), poorly controlled with maximum tolerated medical therapy. Results: Average IOP was reduced from 19.05 ±5.58 mmHg preoperatively to 11.47 ±2.48 mmHg at 3 months postoperatively, 12.26 ±2.48 mmHg at 6 months postoperatively, 14.0 ±2.43 mmHg at 12 months postoperatively, 11.78 ±2.37 mmHg at 18 months postoperatively, and 12.73 ±2.51 mmHg at 24 months postoperatively (p < 0.001). No antiglaucoma medication was required in 19 eyes 3 months after surgery, in 19 eyes 6 months after surgery, 19 eyes 12 months after surgery, 16 eyes 18 months after surgery and 15 eyes 24 months after surgery. One eye (5.26%) required monotherapy 18 months after surgery, and 2 eyes (10.52%) 24 months after surgery. Dual combination therapy was required 18 months after surgery in 2 eyes (10.52%) and 24 months after surgery in 2 eyes (10.52%). In the early postoperative period we found a loose conjunctival suture in 3 eyes, which was followed by resuturing in 1 eye. In the late postoperative period we found an obturated implant in 1 eye, which required implant replacement. Conclusion: Our initial results suggest that the PRESERFLO™ MicroShunt glaucoma implant is an effective surgical technique with minimal postoperative complications, resulting in a statistically significant reduction in average IOP and discontinuation or reduction of topical antiglaucoma medication for 2 years after surgery.
BACKGROUND: Psychosocial crisis management interventions do not sufficiently consider visually impaired and deaf individuals. There are difficulties in accessing the available interventions, and the effectiveness of these interventions seems questionable. The United Nations Convention on the Rights of Persons with Disabilities build on the premises of the inclusive participation in psychosocial intervention after disasters. OBJECTIVE: The objective of this study is to provide recommendations for psychosocial intervention for sensory-impaired individuals after disasters and to raise awareness for professionals working in the field of psychotraumatology. METHODS: A qualitative analysis of semistructured expert interviews and focus groups with professionals in psychotraumatology and sensory-impaired individuals was conducted. This research took place within the European Network for Psychosocial Crisis Management: Assisting Disabled in Case of Disaster (EUNAD), which is funded by the European Commission. RESULTS: There is a need for specific knowledge about how to meet the needs of individuals with sensory loss in order to provide psychosocial crisis management after a disaster. This aspect is not included in the existing psychosocial interventions. CONCLUSION: The EUNAD recommendations are a start to fulfill the obligation to include sensory-impaired individuals in preparations for disaster interventions.
- MeSH
- Disasters * MeSH
- Crisis Intervention * methods MeSH
- Qualitative Research MeSH
- Humans MeSH
- Disaster Planning * MeSH
- Persons with Disabilities * psychology MeSH
- Interviews as Topic MeSH
- Focus Groups MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Geographicals
- Europe MeSH
Intracranial human brain recordings from multiple implanted depth electrodes using stereo-EEG (sEEG) technology for seizure localization provide unique local field potential signals (LFP) sampled with standard macro- and special micro-electrode contacts. Over one hundred macro- and micro-contact LFP signals localized in particular brain regions were recorded from each sEEG monitoring case as patients engaged in an automated battery of verbal memory and non-verbal gaze movement tasks. Subject eye and vocal responses in both visual and auditory task versions were automatically detected in Polish, Czech, and Slovak languages with accurate timing of the correct and incorrect verbal responses using our web-based transcription tool. The behavioral events, LFP and pupillometric signals were synchronized and stored in a standard BIDS data structure with corresponding metadata. Each dataset contains recordings from at least one battery task performed over at least one day. The same set of 180 common nouns in the three languages was used across different battery tasks and recording days to enable the analysis of selective responses to specific word stimuli.
- MeSH
- Electroencephalography MeSH
- Language MeSH
- Cognition * MeSH
- Humans MeSH
- Brain * physiology MeSH
- Eye Movements MeSH
- Eye-Tracking Technology MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Dataset MeSH
Digestivní endoskopie, klíčová metoda pro diagnostiku a léčbu onemocnění gastrointestinálního traktu, se neustále vyvíjí. Novinky v této oblasti zahrnují pokroky v technologii, nové diagnostické techniky a inovace v terapeutických přístupech. Moderní endoskopická zařízení nyní nabízejí vyšší rozlišení obrazu díky pokročilé optice a kamerovým systémům, což umožňuje lépe identifikovat a charakterizovat patologické změny v gastrointestinálním traktu. Nový vývoj technik jako je endoskopická ultrasonografie (EUS), rozšiřuje možnosti diagnostiky tím, že umožňuje vizualizaci hloubkových struktur a vyšetření okolních tkání. Cholangioskopie vhodně doplňuje endoskopickou retrográdní cholangiopankreatikografii (ERCP) v diagnostice biliárních stenóz nejasné etiologie a umožňuje jejich cílenou biopsii. Enteroskopie přinesla významné rozšíření diagnostických a terapeutických postupů zaměřených na tenké střevo. V terapeutických přístupech zaznamenáváme rozvoj minimálně invazivních metod, které umožňují odstranění lézí a léčbu různých gastrointestinálních onemocnění bez nutnosti otevřené chirurgické intervence. Tyto inovace nejen zvyšují přesnost diagnostiky, ale také rozšiřují možnosti léčby, čímž přispívají k lepší péči o pacienty. Budoucnost digestivní endoskopie bude pravděpodobně zaměřena na další zlepšení endoskopických technik s cílem optimalizovat výsledky a minimalizovat invazivitu, a také využití umělé inteligence.
Digestive endoscopy, a key method for the diagnosis and treatment of diseases of the gastrointestinal tract, is constantly evolving. New developments in this field include advances in technology, new diagnostic techniques, and innovations in therapeutic approaches. Modern endoscopic equipment now offers higher image resolution thanks to advanced optics and camera systems, which allow better identification and characterization of pathological changes in the gastrointestinal tract. New techniques, such as endoscopic ultrasonography (EUS), are expanding diagnostic capabilities by allowing visualization of deep structures and examination of surrounding tissues. Cholangioscopy appropriately complements endoscopic retrograde cholangiopancreatography (ERCP) in the diagnosis of biliary strictures of uncertain etiology and allows their targeted biopsy. Enteroscopy has brought a significant extension of diagnostic and therapeutic procedures targeting the small intestine. In therapeutic approaches, we have seen the development of minimally invasive methods that allow the removal of lesions and the treatment of various gastrointestinal diseases without the need for open surgical intervention. These innovations not only increase the accuracy of diagnosis but also expand treatment options, thus contributing to better patient care. The future of digestive endoscopy will likely focus on further improvements in endoscopic techniques to optimize outcomes and minimize invasiveness.
- MeSH
- Endoscopic Mucosal Resection methods instrumentation MeSH
- Endoscopy, Digestive System * classification methods instrumentation MeSH
- Endosonography classification methods MeSH
- Endoscopy, Gastrointestinal classification methods MeSH
- Humans MeSH
- Digestive System Diseases * diagnostic imaging pathology therapy MeSH
- Bile Ducts diagnostic imaging MeSH
- Check Tag
- Humans MeSH
- Publication type
- Review MeSH
Cíle: Prokázat závislost velikosti tloušťky vrstvy nervových vláken na sítnici a funkční citlivosti sítnice u zdravých mladých jedinců. Sekundárně jsme také zkoumali závislost refrakční vady a průměrné tloušťky sítnice v makule. Materiál a metody: Základní soubor obsahoval 30 subjektů s průměrným věkem 23,4 ±4,2 let. Jednalo se o mladé, celkově zdravé jedince bez závažných očních patologií. Průměrná hodnota sférického ekvivalentu u obou očí všech jedinců byla -1,2 ±2,5 D. Měření tloušťky vrstvy nervových vláken v oblasti papily (RNFL) a průměrné tloušťky sítnice v oblasti makuly jsme prováděli přístrojem OPKO Spectral OCT SLO Combination Imaging System (Opko Health, USA). Funkční vyšetření sítnice v oblasti do 30° jsme prováděli za pomocí perimetru s technologií zdvojené frekvence (FDT – Frequency Doubling Technology) od firmy Humphrey (Carl Ziess Meditec, Inc., Dublin, CA). Pro naši studii jsme jako významnou proměnnou stanovili hodnotu průměrné odchylky citlivosti sítnice (MD). Výsledky: V naší studii jsme neprokázali statisticky významnou závislost mezi průměrnou tloušťkou vrstvy nervových vláken na sítnici (RNFL) a průměrnou hodnotou funkční citlivosti sítnice (r = 0,18, p = 0,34) u pravých očí a také u levých očí vyšetřovaných subjektů (r = 0,20, p = 0,29). Statisticky významnou závislost jsme také sekundárně nenalezli mezi proměnou nazvanou sférický ekvivalent refrakční vady (SE) a průměrnou tloušťkou sítnice v makule u pravých očí (r = 0,34, p = 0,06) a levých očí (r = 0,18, p = 0,32). Závěr: Při porovnání průměrné velikosti tloušťky nervových vláken v papile za pomoci OCT vyšetření a funkční citlivosti sítnice měřené na FDT perimetru jsme nenalezli statisticky významnou závislost ve skupině pravých očí ani ve skupině levých očí. Podobného výsledku jsme také dosáhli při zkoumání vzájemné závislosti proměnných sférický ekvivalent refrakční vady oka (SE) a průměrná tloušťka sítnice v makule.
Aims: To demonstrate the relationship of dependency between the thickness of the retinal nerve fiber layer and the functional sensitivity of the retina in healthy young individuals. We also secondarily investigated the relationship between refractive error and mean retinal thickness in the macula. Material and methods: The basic cohort contained 30 subjects with an average age of 23.4 ±4.2 years. These were young, generally healthy individuals without serious ocular pathologies. The average value of spherical equivalent in both eyes of all individuals was -1.2 ±2.5 D. We measured the thickness of the retinal nerve fiber layer (RNFL) in the papilla area and the average thickness of the retina in the area of the macula using the device OPKO Spectral OCT SLO Combination Imaging System (Opko Health, USA). We performed a functional examination of the retina within an area up to 30° using a perimeter with a stimulus with a Frequency Doubling Technology (FDT) from the company Humphrey (Carl Ziess Meditec, Inc., Dublin, CA). As a significant variable for comparison, we determined the mean value of retinal sensitivity deviation (MD). Results: In our study, we did not demonstrate a statistically significant relationship between the average thickness of the retinal nerve fiber layer (RNFL) and the average value of retinal functional sensitivity (r = 0.18, p = 0.34) in either right eyes or the left eyes of the examined subjects (r = 0.20, p = 0.29). We also did not find a statistically significant relationship secondarily between the variable called the spherical equivalent of refractive error (SE) and the average retinal thickness in the macula in either the right eyes (r = 0.34, p = 0.06) or the left eyes (r = 0.18, p = 0.32). Conclusion: When comparing the average thickness of the nerve fibers in the papilla with the help of OCT examination and the functional sensitivity of the retina measured on an FDT perimeter, we did not find a statistically significant dependence in the group of right eyes or in the group of left eyes. We also achieved a similar result when examining the interdependence of the variables of spherical equivalent of refractive error of the eye and the average thickness of the retina in the macula.
- MeSH
- Adult MeSH
- Clinical Studies as Topic MeSH
- Humans MeSH
- Young Adult MeSH
- Nerve Fibers * physiology pathology MeSH
- Tomography, Optical Coherence methods MeSH
- Refractive Errors physiopathology MeSH
- Retina * diagnostic imaging MeSH
- Visual Field Tests MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Young Adult MeSH
- Male MeSH
- Female MeSH
A case report of a 70-year-old woman who had never suffered from any eye disease is presented. It was found that 2 weeks prior to the ophthalmological examination at another clinic 'something fell' into her right eye; she noticed a decline in the vision of her the left eye. On ophthalmologic examination Visual Acuity, Right Eye (VARE) was 0.4 and Visual Acuity, Left Eye (VALE): fingers at 1 m. Incipient cataracts in both eyes, more on the right. On optic nerve (ON) evaluation, the optic papilla cup-to-disk ratio (C/D) was=0.6 and 0.7, R/L, respectively. A total of 1 month after the first examination VARE was found: 0.4 and VALE: 0.16. The cataracts did not correspond to the decrease in visual acuity. an excavation on the right papilla (C/D=0.6) was found and the left papilla was atrophic (C/D=0.7). Otherwise, the fundus evaluation was normal. Incomplete upper temporal quadrantanopia on the right visual field (VF) and temporal hemianopia extending into the central part on the left VF were identified. An electrophysiological examination (pattern visual evoked responses) showed a marked decrease in amplitudes on the right and no prolongation of P100 latency; a non-excitable reaction was observed in the left. Our finding was chiasmatic syndrome with more significant impairment on the left side. Subsequent magnetic resonance imaging (MRI) was suspicious for Rathke's cleft cyst (RCC). A neurosurgical intervention was performed the week following MRI . Using a subfrontal approach via a small right frontal craniotomy, the tumor was released from surrounding neural structures and radically removed using microsurgical techniques. During the procedure, it was not completely clear whether it was RCC or a craniopharyngioma; the biopsy findings were consistent with RCC with xanthogranulomatous changes. The authors emphasize the importance of visual field examination in unclear visual disorders, as well as the importance of follow-up examinations to uncover recurrences.
- Publication type
- Journal Article MeSH
- Case Reports MeSH
Aim: To present on video our current most used technique of robot-assisted resection of renal tumour (RR). Material: We performed 274 RRs between June 2020 and November 2024. Our technique is based on a modification of conventional laparoscopic renal resection, of which we performed 599 between August 2004 and May 2020. RRs currently account for over one third of the surgical procedures for kidney cancer at our institution. Laparoscopic (rarely robotic assisted) nephrectomy is almost as frequent. Open resection accounts for about 17% and open nephrectomy for slightly less. Open resections are mainly indicated for more complex tumours, for tumors with significant \"toxic\" fat capsule, and when combined with other procedures, mostly for intestinal malignancies. RR is routinely performed by two console surgeons, occasionally by two additional ones. Operation technique: General anaesthesia. Optional urinary catheter inserted. Lateral position 60-70°. Upper limbs extended in front, close together. Operative field prepared for eventual lumbotomy. Transperitoneal approach. The capnoperitoneum is created with a Veres needle, CO2 pressure 12 mmHg. Assist port 12 mm slightly lateral to the umbilicus. Four 8-mm robotic ports are inserted pararectally under visual control. Four-arm daVinci Xi robotic system is inserted. Ports craniocaudally: 1. ProGrasp, 2. bipolar grasper (bipolar forceps Maryland or more often fenestrated) or monopolar curved scissors (Hot shears) according to the operated side and the dominant hand of the operator, 3. camera 30°, 4. the second of the mentioned instruments from port 2. The scissors are alternated with a needle driver, usually the Large SutureCut needle driver. In the Toldt line, the peritoneum is opened, the colon is retracted medially, and the Gerota fascia is opened medially from the kidney. The necessary part of the kidney is dissected from the fat capsule for good access to the tumour. The tumour is verified sonographically with a drop-in probe inserted through the assistant port. Scissors can be used to mark the line of resection on the kidney. The ureter is verified and the hilar vessels are released. The artery(s) or necessary branch is bypassed with tubing and clamped with the SCANLAN® robotic endo-bulldog. Only in central tumours is the vein also clamped. Knowledge of the topographic anatomy of the vessels from two-phase CT angiography is very helpful at this stage. The effectiveness of ischemia is verified by Doppler; exceptionally (especially in selective clamping of the artery branches) by NIR imaging with FireFly® with administration of indocyanine green - Verdye® 1.25-2.5 mg. The tumour is resected with cold scissors with a rim of healthy tissue. Suturing of the base is performed with an absorbable self-anchoring barbed suture (V-Loc® 90, size 3-0, 1/2 needle 26 mm). The edges of the kidney are mattress sutured with another suture, tightened with Absolok® AP300 absorbable clips (polydioxanone PDS, size ML) - \"sliding clips\" technique. The second layer of the parenchyma is sewn with simple continuation stitches, mostly without continuous anchoring. For more superficial tumours, a straight suture of the parenchyma is
PURPOSE: This study aimed to evaluate early-phase safety of subretinal application of AAVanc80.CAG.USH1Ca1 (OT_USH_101) in wild-type (WT) pigs, examining the effects of a vehicle control, low dose, and high dose. METHODS: Twelve WT pigs (24 eyes) were divided into three groups: four pigs each received bilateral subretinal injections of either vehicle, low dose (3.3 × 1010 vector genomes [vg] per eye), or high dose (1.0 × 1011 vg per eye). Total retinal thickness (TRT) was evaluated using optical coherence tomography and retinal function was assessed with full-field electroretinography (ff-ERG) at baseline and two months post-surgery. After necropsy, retinal changes were examined through histopathology, and human USH1C_a1/harmonin expression was assessed by quantitative PCR (qPCR) and Western blotting. RESULTS: OT_USH_101 led to high USH1C_a1 expression in WT pig retinas without significant TRT changes two months after subretinal injection. The qPCR revealed expression of the human USH1C_a1 transgene delivered by the adeno-associated virus vector. TRT changes were minimal across groups: vehicle (256 ± 21 to 243 ± 18 μm; P = 0.108), low dose (251 ± 32 to 258 ± 30 μm; P = 0.076), and high dose (242 ± 24 to 259 ± 28 μm; P = 0.590). The ff-ERG showed no significant changes in rod or cone responses. Histopathology indicated no severe retinal adverse effects in the vehicle and low dose groups. CONCLUSIONS: Early-phase clinical imaging, electrophysiology, and histopathological assessments indicated that subretinal administration of OT_USH_101 was well tolerated in the low-dose treatment arm. OT_USH_101 treatment resulted in high expression of human USH1C_a1. Although histopathological changes were not severe, more frequent changes were observed in the high-dose group.
- MeSH
- Cytoskeletal Proteins genetics MeSH
- Dependovirus genetics MeSH
- Electroretinography * MeSH
- Genetic Therapy methods MeSH
- Genetic Vectors * MeSH
- Injections, Intraocular * MeSH
- Real-Time Polymerase Chain Reaction MeSH
- Humans MeSH
- Disease Models, Animal MeSH
- Tomography, Optical Coherence * MeSH
- Swine MeSH
- Cell Cycle Proteins genetics MeSH
- Gene Expression Regulation MeSH
- Retina * metabolism pathology MeSH
- Transgenes * MeSH
- Blotting, Western MeSH
- Animals MeSH
- Check Tag
- Humans MeSH
- Animals MeSH
- Publication type
- Journal Article MeSH
- MeSH
- Angiography MeSH
- Radiotherapy Dosage MeSH
- Child MeSH
- Gonioscopy MeSH
- Hemangioma * diagnostic imaging pathology radiotherapy MeSH
- Humans MeSH
- Choroid Neoplasms * diagnostic imaging pathology radiotherapy MeSH
- Tomography, Optical Coherence MeSH
- Visual Field Tests MeSH
- Check Tag
- Child MeSH
- Humans MeSH
- Male MeSH
- Publication type
- Case Reports MeSH
- MeSH
- Middle Aged MeSH
- Humans MeSH
- Vision Disorders * diagnosis MeSH
- Visual Field Tests classification methods MeSH
- Visual Fields * MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Publication type
- Case Reports MeSH
