Search

This consensus document aims to define a standardized protocol for visual function and imaging examinations preceding vitreoretinal surgery. Preoperative examination can significantly aid physicians in defining surgical indications, evaluating patients' conditions, and providing substantial support for designing surgical plans and predicting prognoses. Compiled by a collaborative expert group representing the Ophthalmic Imaging and Intelligent Medicine Branch of the Chinese Medicine Education Association, in tandem with the Ophthalmology Committee of International Association of Translational Medicine, this consensus integrates recent advancements and research in vitreoretinal surgery from both global and domestic contexts. Following numerous rounds of deliberations and the integration of the latest clinical data, these consensuses have been formulated with the objective of offering support in standardizing preoperative examinations for vitreoretinal surgery, with the broader aim of enhancing medical quality, optimizing resource usage, providing decision-making support, and ensuring the protection of patient rights. This document predominantly encompasses an in-depth review of preoperative examinations for vitreoretinal procedures, which includes, but is not limited to, principles, methodologies, and related precautions of ultra-wide-angle fundus imaging, fluorescein angiography, indocyanine green angiography, ophthalmic B-ultrasound examinations, ultrasound biomicroscopy, optical coherence tomography, optical coherence tomography angiography, orbital CT scan, orbital MRI, ophthalmic electrophysiology tests such as electroretinogram and visually evoked potentials and visual field.

Abstract Background There have been few reports showing the relationship between blood pressure (BP) measured at clinics preoperatively and BP measured before anesthetic intubation/induction. The purpose of this study was to examine the relationship between BP measured at different times and settings preoperatively and BP measured before intubation/induction. Methods A total of 182 patients who underwent general anesthesia between March 2021 and April 2022 in a university hospital were examined. In addition to self-reported BP asked on an anesthetic examination sheet completed by each patient, BPs were measured three times, before, during, and after preoperative examination by the anesthesiologist. The derived parameter was compared with BP measured before intubation at the time of general anesthesia induction. Results The systolic BP in the intra-examination period had the most significant correlation with pre-intubation systolic BP (r = 0.5230, p

Abstract Background Anal fistula is a common benign anorectal disease that often requires surgical intervention for effective treatment. In recent years, preoperative colonoscopy as a diagnostic tool in patients with anal fistula has garnered increasing attention due to its potential clinical application value. By investigating underlying inflammatory bowel disease (IBD), polyps, and other abnormalities, preoperative colonoscopy can offer insights to refine surgical strategies and improve patient outcomes. Methods This retrospective study focused on 1796 patients with various benign anorectal diseases who underwent preoperative intestinal endoscopy and met surgical criteria within the preceding three years at the First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine. Among these patients, 949 diagnosed with anal fistula comprised group A, while 847 patients without anal fistula were assigned to group B for comparison. The investigation encompassed an analysis of general patient information, endoscopic findings, polyp histopathology, distribution of bowel inflammation sites, and results of inflammatory bowel disease assessments between the two patient cohorts. A subgroup analysis was also conducted on 2275 anal fistula patients with no surgical contraindications. This subgroup was categorized into Group A (949 patients who underwent preoperative intestinal endoscopy) and Group C (1326 patients who did not undergo preoperative colonoscopy). The study compared the rates of detecting endoscopic lesions and IBD-related findings between the two subgroups. Results The study initially confirmed the comparability of general patient information between groups A and B. Notably, the abnormal detection rate in group A was significantly higher than in group B (P 0.05). Subsequently, the analysis of the subgroup (groups A and C) revealed a significant disparity in intestinal endoscopic detection rates (P

Infective endocarditis (IE) is a rare but devastating disease. The main complications of IE are heart failure (HF), sepsis (in particular, due to perivascular spread of infection), and embolic events, most often those of cerebral local-ization. The diagnosis of IE combines various factors that are not specific to IE when considered separately. Echocardiog-raphy remains the first-line imaging modality for the diagnosis of IE. The aim. To determine the features of intracardiac complications that occur in patients with IE at the preoperative stage using ultrasound diagnostics. Materials and methods. The study included clinical data of 120 patients with IE who underwent examination and treatment from 01/01/2019 to 06/30/2020 at the National Amosov Institute of Cardiovascular Surgery of the National Academy of Medical Sciences of Ukraine. The diagnosis of IE was established in accordance with the modified Duke/Eu-ropean Society of Cardiology 2015 criteria. The mean age of the studied patients was 46.3 ± 1.37 (19-69 years). Results. A high rate of nosocomial factors in the development of the disease was determined: 49 (40.9%) cases, of which 15 (12.5%) cases and 25 (20.8%) cases were urological and general surgical interventions, respectively. Preopera-tive HF was found in 16 (13.3%) cases. In the group of patients with acute HF, cases of left heart valve disease with peri-annular complications dominated: 9 (56.3%) cases of abscesses and 3 (18.8%) cases of fistulae. Significant differences were found in the assessment of the cardiac index: in the group of patients with IE without signs of HF, the cardiac index was 4.9 ± 0.2, and in the group of patients with preoperative HF it was 3.7 ± 0.4 (p = 0.098). Patients with acute HF were characterized by a higher level of acute kidney injury (creatinine 168.2 ± 40.7 μmol/L, urea 13.3 ± 2.5 mmol/L). Conclusions. The obtained results indicate a high incidence of intracardiac complications in patients with IE, in par-ticular, those caused by nosocomial infections and medical interventions. Ultrasound diagnostics (echocardiography) is an important tool for detecting and monitoring intracardiac complications at the preoperative stage, which can affect the treatment strategy and prognosis. A thorough examination of a patient with IE allows to identify critical features of cardiac hemodynamic disorders and ensure timely cardiac surgery.

Background: There have been few reports showing the relationship between blood pressure (BP) measured at clinics preoperatively and BP measured before anesthetic intubation/induction. The purpose of this study was to examine the relationship between BP measured at different times and settings preoperatively and BP measured before intubation/induction. Methods: A total of 182 patients who underwent general anesthesia between March 2021 and April 2022 in a university hospital were examined. In addition to self-reported BP asked on an anesthetic examination sheet completed by each patient, BPs were measured three times, before, during, and after preoperative examination by the anesthesiologist. The derived parameter was compared with BP measured before intubation at the time of general anesthesia induction. Results: The systolic BP in the intra-examination period had the most significant correlation with pre-intubation systolic BP (r = 0.5230, p < 0.0001, 95% CI = 0.4050 to 0.6238). On Bland–Altman analysis, the intra-examination systolic BP seemed to be similar and showed better agreement with pre-intubation systolic BP than other measured BPs, with a mean bias of 2.2 mmHg and the narrowest 95% limits of agreement (-33.7 to + 38.1 mmHg). Conclusions: The preoperative systolic BP value measured during the examination by the anesthesiologist was found to be closely related to pre-intubation systolic BP measured in the operating room. Higher BP during the preoperative examination may be a result of anxiety-induced stress or white-coat hypertension. Measuring BP during the anesthesiologist's examination may be useful for predicting hypertension in the pre-intubation period. [ABSTRACT FROM AUTHOR]

Background: Anal fistula is a common benign anorectal disease that often requires surgical intervention for effective treatment. In recent years, preoperative colonoscopy as a diagnostic tool in patients with anal fistula has garnered increasing attention due to its potential clinical application value. By investigating underlying inflammatory bowel disease (IBD), polyps, and other abnormalities, preoperative colonoscopy can offer insights to refine surgical strategies and improve patient outcomes. Methods: This retrospective study focused on 1796 patients with various benign anorectal diseases who underwent preoperative intestinal endoscopy and met surgical criteria within the preceding three years at the First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine. Among these patients, 949 diagnosed with anal fistula comprised group A, while 847 patients without anal fistula were assigned to group B for comparison. The investigation encompassed an analysis of general patient information, endoscopic findings, polyp histopathology, distribution of bowel inflammation sites, and results of inflammatory bowel disease assessments between the two patient cohorts. A subgroup analysis was also conducted on 2275 anal fistula patients with no surgical contraindications. This subgroup was categorized into Group A (949 patients who underwent preoperative intestinal endoscopy) and Group C (1326 patients who did not undergo preoperative colonoscopy). The study compared the rates of detecting endoscopic lesions and IBD-related findings between the two subgroups. Results: The study initially confirmed the comparability of general patient information between groups A and B. Notably, the abnormal detection rate in group A was significantly higher than in group B (P < 0.01). In terms of endoscopic findings, the anal fistula group (group A) exhibited higher rates of detecting bowel inflammation, inflammatory bowel disease, and polyps compared to the non-anal fistula group (group B) (P < 0.05). The distribution of inflammation locations indicated higher detection rates in the terminal ileum, ileocecal region, and ascending colon for group A compared to group B (P < 0.05). Although the incidence of IBD in group A was higher than in group B, this difference did not reach statistical significance (P > 0.05). Subsequently, the analysis of the subgroup (groups A and C) revealed a significant disparity in intestinal endoscopic detection rates (P < 0.01) and statistically significant differences in detecting IBD (P < 0.05) and Crohn's disease (P < 0.05) between the two anal fistula subgroups. Conclusions: The findings of this study underscore the substantial clinical value of preoperative colonoscopy in the comprehensive evaluation of patients with anal fistula. Preoperative colonoscopy aids in ruling out localized perianal lesions caused by underlying inflammatory bowel disease, thereby mitigating the likelihood of missed diagnoses and enhancing treatment outcomes. This research highlights the importance of incorporating preoperative colonoscopy as a valuable diagnostic tool in managing anal fistula patients. [ABSTRACT FROM AUTHOR]

Failure to identify a difficult airway can have serious consequences. It is essential that a thorough assessment of a patient's airway is made prior to anaesthesia, including taking a history, performing a focused examination, and reviewing any relevant investigations. The predictive power of individual bedside airway assessments is limited, though the use of composite scores may increase accuracy. Where predictors of potential difficulty are identified, these must be taken into account when formulating an appropriate airway management strategy and executing it. Despite thorough preoperative evaluation and planning, situations still arise where an unexpected difficult airway is encountered, where maintenance of adequate oxygenation must take precedence. [ABSTRACT FROM AUTHOR]

Background: Tracheal extubation is a critical stage in the management of general anaesthesia during which serious complications may occur. Immediately before extubation, patients often exhibit signs that suggest that they are awake and experiencing discomfort. There is concern that patients may retain such memories of the extubation process. However, previous studies have not examined patient recall of extubation in detail. We therefore investigated the frequency of recall of discomfort during extubation, as well as first orientation to place, and other recollections upon emerging from general anaesthesia. Methods: In a prospective observational study, 818 patients were interviewed during routine post-anaesthesia rounds on the day after general anaesthesia. The primary outcome was the proportion of patients recalling discomfort during extubation. The secondary outcome was the location of orientation to place upon emerging from general anaesthesia. Results: Recall of discomfort during extubation was uncommon, at 1.1% (n=9; 95% confidence interval [CI]: 0.5–2.1%). Only 3.1% of patients recalled the extubation process at all (n=25; 95% CI: 2.0–4.5%). The first orientation to place was most commonly in transit to a ward, in 41% of cases (n=337; 95% CI: 38–45%). Conclusions: Recall of discomfort during extubation appears to be rare, and the great majority of patients may not retain any memory of the extubation process. This information may be used to reassure patients and guide extubation practices for anaesthetists. Clinical trial registration: UMIN Clinical Trials Registry (UMIN000046136).

A total of 215 patients with coronary heart disease (CHD) were analyzed with SPSS. Samples of different genders showed significance in the obtuse marginal branch of the left circumflex branch × 1, the diagonal branch D1 × 1, and the ms PV representation. Patients with left circumflex branch occlusion are more male and tend to be younger. Age displayed a positive correlation with left intima-media thickness (IMT) and right IMT. This indicated that as age increases, the values of left IMT and right IMT increase. Samples of different CHD types showed significance in the obtuse marginal branch of the left circumflex branch × 1, the middle part of RCA × 1, and the middle part of the left anterior descending branch × 1.5. For non-ST-segment elevation angina pectoris with acute total vascular occlusion, the left circumflex artery is the most common, followed by the right coronary artery and anterior descending branch. Ultrasound of carotid IMT in patients with CHD can predict changes in left ventricular function, but no specific correlation between left and right common carotid IMT was found. Samples with or without the medical history of ASCVD showed significance in the branch number of coronary vessel lesions. The value of the branch number of coronary vessel lesions in patients with atherosclerotic cardiovascular disease (ASCVD) was higher than in those without ASCVD. The occurrence of complication is significantly relative with the distance of left circumflex branch × 1, the middle segment of left anterior descending branch × 1.5, and the distance of left anterior descending branch × 1. For patients without complications, the values in the distal left circumflex branch × 1, the middle left anterior descending branch × 1.5, and the distal left anterior descending branch × 1 were higher than those for patients with complications. The VTE scores showed a positive correlation with the proximal part of RCA × 1, the branch number of coronary vessel lesions, the posterior descending branch of left circumflex branch × 1, the distal part of left circumflex branch × 1, and the middle part of left anterior descending branch × 1.5.

Copyright of Imaging Science & Photochemistry is the property of Imaging Science & Photochemistry Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim: The aim of this study was to reduce the severe respiratory complications of esophageal cancer surgery often leading to death. Methods: Two groups of patients operated on for esophageal cancer were evaluated in this retrospective analysis. The first group was operated between 2006-2011, prior to the implementation of preoperative microbiological examination while the second group had surgery between 2012-2017 after implementation of this examination. Results: In total, 260 patients, 220 males and 40 females underwent esophagectomy. Between 2006-2011, 113 (87.6%) males and 16 (12.4%) females and between 2012-2017, esophagectomy was performed in 107 (81.7%) males and 24 (18.3%) females. In the first cohort, 10 patients died due to respiratory complications. The 30-day mortality was 6.9% and 90-day was 9.3%. In the second cohort, 4 patients died from respiratory complications. The 30-day mortality was 1.5% and 90-day mortality was 3.1%. With regard to the incidence of respiratory complications (P=0.014), these occurred more frequently in patients with sputum collection, however, severe respiratory complications were more often observed in patients without sputum collection. Significantly fewer patients died (P=0.036) in the group with sputum collection. The incidence of respiratory complications was very significantly higher in the patients who died (P

Purpose: The combination of obesity and diabetes mellitus are well-known risk factors for cardiovascular complications and perioperative morbidity in metabolic surgery. The aim of this study was to evaluate effectivity and reliability of the cardiac assessment in patients with diabetes prior to bariatric surgery. Setting: Private, university-affiliated teaching hospital, Switzerland Material and Methods: Retrospective analysis of prospectively collected data on results and consequences of cardiac assessments in 258 patients with obesity and diabetes scheduled for primary bariatric surgery at our institution between January 2010 and December 2018. Results: Out of 258 patients, 246 (95.3%) received cardiac diagnostics: 173 (67.1%) underwent stress-rest myocardial perfusion scintigraphy (MPS), 15 (5.8%) patients had other cardiac imaging including cardiac catheterization, 58 (22.5%) patients had echocardiography and/or stress electrocardiography, and 12 (4.7%) patients received no cardiac evaluation. Subsequently, cardiac catheterization was performed in 28 patients (10.9%), and coronary heart disease was detected and treated in 15 subjects (5.8%). Of these 15 individuals, 5 (33.3%) patients had diffuse vascular sclerosis, 8 (53.3%) patients underwent coronary angioplasty and stenting, and 2 (13.3%) patients coronary artery bypass surgery. Bariatric surgery was performed without perioperative cardiovascular events in all 258 patients. Conclusion: Our data suggest that a detailed cardiac assessment is mandatory in bariatric patients with diabetes to identify those with yet unknown cardiovascular disease before performing bariatric surgery. We recommend carrying out myocardial perfusion scintigraphy as a reliable diagnostic tool in this vulnerable population. If not viable, stress echocardiography should be performed as a minimum. [ABSTRACT FROM AUTHOR]

Objective : The objective of this paper is to reconsider the significance of preoperative chest radiography (CXR) before ophthalmic surgery through investigation of imaging findings and usage status. Methods : This retrospective observational clinical study involved 1616 patients who underwent ophthalmic surgery at Saga University Hospital from 1 January 2019 to 31 December 2020. The patients' radiology reports were obtained from the electronic medical records, and their CXR findings, therapeutic interventions, and progress were investigated. Results : Among all patients, 539 (33.4%) had abnormal preoperative CXR findings. Of these patients, 74 (4.6%) had newly identified abnormal findings. In both patient groups, approximately 70% of patients with abnormal findings were aged ≥70 years, and interstitial shadows were the most common finding. Among all patients with abnormal findings, three (0.19%) received preoperative therapeutic interventions, and all surgeries were performed safely. Forty-three patients with abnormal findings were referred to our hospital or other hospitals for further investigation and treatment postoperatively. Among those patients, eight (0.5%) had primary lung cancer, seven underwent surgery, and one received chemoradiation. The other patients were also followed up and received appropriate therapeutic interventions. Conclusions : Before ophthalmic surgery, few patients required actual therapeutic interventions based on their CXR results. However, many abnormal findings were revealed in elderly patients, including some serious diseases. Furthermore, research has suggested that appropriate therapeutic intervention after ophthalmologic surgery may reduce the risk of a poor life prognosis. This study clearly shows that preoperative CXR is not only useful for perioperative systemic management but also ultimately benefits patients. It is also considered particularly meaningful for patients aged ≥70 years.

Objective. To specify the extent of preoperative examination of patients with lumbar degenerative diseases and to study the effect of ex- amination results on the tactics of surgical treatment. Material and Methods. The study included retrospective analysis of 1340 patients with lumbar degenerative diseases treated in the Neu- rosurgical Department No. 2 of Novosibirsk RITO n.a. Ya.L. Tsivyan during 2017. Results. The average height of the intervertebral disc as evaluated with MRI was 7.4 ± 1.8 mm, and that evaluated with MSCT – 4.9 ± 1.5 mm, with a statistically significant difference between them (p < 0.05). Immediate preoperative examination of patients with lumbar disc herniation showed reduction or lysis of the hernia fragment in some of them. Reduction of the leg pain and hernia size (by more than 50 %) and lysis of the herniated disc fragment evidenced by MRI were observed in 21 (3.2 %) patients. Comparison of the pre- planned and actually performed extent of decompression and stabilization interventions showed that tactics and/or extent of surgical treatment changed in 37.6 % of cases. Conclusion. The complex of instrumental radiological and neuroimaging studies, as well as methods of provocative procedure in the lum- bar spine performed immediately before the planned surgical treatment allow choosing the proper treatment tactics, specifying or correct- ing the volume of surgical treatment, and to prognosing its outcome in lumbar degenerative diseases.

Aim. The aim of this study was to reduce the severe respiratory complications of esophageal cancer surgery often leading to death. Methods. Two groups of patients operated on for esophageal cancer were evaluated in this retrospective analysis. The first group was operated between 2006-2011, prior to the implementation of preoperative microbiological examination while the second group had surgery between 2012-2017 after implementation of this examination. Results. In total, 260 patients, 220 males and 40 females underwent esophagectomy. Between 2006-2011, 113 (87.6%) males and 16 (12.4%) females and between 2012-2017, esophagectomy was performed in 107 (81.7%) males and 24 (18.3%) females. In the first cohort, 10 patients died due to respiratory complications. The 30-day mortality was 6.9% and 90-day was 9.3%. In the second cohort, 4 patients died from respiratory complications. The 30-day mortality was 1.5% and 90-day mortality was 3.1%. With regard to the incidence of respiratory complications (P=0.014), these occurred more frequently in patients with sputum collection, however, severe respiratory complications were more often observed in patients without sputum collection. Significantly fewer patients died (P=0.036) in the group with sputum collection. The incidence of respiratory complications was very significantly higher in the patients who died (P<0.0001). Conclusion. The incidence of severe respiratory complications (causing death) may be reduced by identifying clinically silent respiratory tract infections. [ABSTRACT FROM AUTHOR]

Failure to identify a difficult airway can have serious consequences. It is essential that a thorough assessment of a patient's airway is made, including history and a focussed examination. It is known that the reliability of preoperative assessment is disappointing but positive findings will allow for an appropriate airway management plan to be devised in order to minimize airway-related complications. Despite this, situations will still occur where an unexpected difficult airway is encountered. [ABSTRACT FROM AUTHOR]

Objectives: To determine the efficacy of Mini-CEX in assessing clinical expertise of anesthesia trainee during examination at Anesthesia department of Multan Hospitals. Study Design: Prospective Observational Study. Setting: Department of Anesthesia and Intensive Care Ch. Pervez Ellahi Institute of Cardiology and Nishtar Hospital Multan. Period: January 2017 to March 2019. Material & Methods: The design of study was prospective observational study having the post-test with control group only. The size of the sample was based upon 70 trainee anesthesia being divided into two further groups: 35 trainee anesthesia were included in the control group whereas 35 trainee were part of the intervention group. The analysis of data was done by Mann Whitney test and it was descriptive type of test. Results: The mean result of Preoperative examination skills among the intervention group was greater than the control group. The mean score of Preoperative examination competence in control group was 72.11±4.56, while the mean score of Preoperative examination competence in intervention group was 81.28±2.86. The mean score of anesthesia trainees towards satisfaction of control and intervention group was 5.37±0.38 and 8.95±0.64, respectively. While the mean score of evaluators towards satisfaction of control and intervention group was 6.24±0.53 and 8.04±0.52, respectively. The difference of clinical abilities was significant among the two groups having the p value 0.000 (p<0.05). Conclusion: Clinical expertise among anesthesia trainee was significantly ameliorated after the use of Mini-CEX program. It is therefore suggested for anesthesia trainers to use the Mini-CEX program in order to determine the clinical skills among students. [ABSTRACT FROM AUTHOR]

An article presents an analysis of treatment of 113 patients (aged from 60 to 91 years old) with stomach cancer. On this basis, an algorithm of examination of given age group was developed. Preoperative diagnostics wasn’t directed only to an establishment of prevalence, a stage of main process. At the same time, it was aimed to determination and correction of accompanying somatic pathology, which required an application of multidisciplinary approach. An echocardiography was used for a functional condition assessment of cardiovascular and respiratory systems. The strategy allowed the indication rise for operation up to 96,5% in given group of patients.

To further standardize the surgical procedures of combined liver and kidney transplantation, organ transplantation experts of Branch of Organ Transplantation of Chinese Medical Association have formulated the surgical specifications of combined liver and kidney transplantation from the perspectives of indications and contraindications, preoperative examination and preparation of the recipients, surgical standards for donor liver and kidney repair, operational standards for anesthesia, surgical standards for organ implantation, common postoperative complications and treatment, diagnosis and treatment of postoperative rejection, application principles and routine regimes of immunosuppressants and postoperative follow-up in combined liver and kidney transplantation, etc. [ABSTRACT FROM AUTHOR]

Frequent epileptic seizures and side effects of drugs have a significant negative impact on the quality of life. The main goal in the treatment of such patients is not only to decrease the number of attacks and their severity, but also to improve social adaptation. Surgical treatment for some forms of pharmacoresistant epilepsy improves prognosis and enhances the quality of life of patients, and the result depends on the duration of the disease. The main task of the preoperative examination is the most accurate localization of the epileptogenic zone. In the case of proximity or the overlapping of the epileptogenic zone with functionally significant parts of the crust, additional surveys to determine the latter are conducted. The survey may be conducted using non-invasive techniques, such as MRI, functional MRI, positron emission tomography (PET), single photon emission computed tomography (SPECT) and extracranial electrical stimulation or invasive direct electrical stimulation of the cortex.

Objective: To create a formalized method for predicting papillary thyroid cancer recurrence after hemithyroidectomy based on preoperative data., Material and Methods: At this stage of the study, we selected 101 patients with papillary thyroid cancer who underwent surgical treatment in 2017-2023. Recurrence was observed in in 47 patients. Fifty-four patients had no recurrence within 5 years after surgical treatment, i.e. these patients underwent surgery in 2017-2018. To find prediction rules, we used original classification method based on searching for subsets of variables and piecewise linear rules separating classes in pairs with subsequent voting of such rules to make a decision., Results: The exam was carried out using a training sample (101 cases) and sliding control method (10 tests on 10 random cases). On the training sample, sensitivity of predictive algorithm was 91%, specificity 78% and error rate 13%. The aggregated result of 10 trials using sliding control method revealed sensitivity of predictive algorithm 86%, specificity 75% and error rate 15%. This result is close to overall sample and confirms the effectiveness of this method for predicting recurrence., Conclusion: The pilot experiments revealed the patterns in data for potential prediction of recurrence based on preoperative indicators. Further study of this problem may be valuable for decision-making and adjustments in the management of patients with papillary thyroid cancer.

AIM:To investigate the clinical value of optical coherence tomography(OCT)combined with ophthalmic B-type ultrasound in fundus examination before cataract surgeries.METHODS:Conventional ophthalmoscope, ophthalmic B-type ultrasound and OCT were used to exam the fundus of 176 cataract patients(278 eyes). The positive rate of fundus diseases by the three methods was calculated, and then McNemar test was used to analyze the data in pairs and the values of the three methods on diagnosis of fundus diseases were investigated.RESULTS:Thirty-two eyes were diagnosed with fundus diseases by conventional ophthalmoscope with positive rate of 11.5%, 18 eyes(6.5%)by ophthalmic B-type ultrasound, 6 eyes(2.2%)of those 18 eyes were serious lens turbidity. Fifty-one eyes(18.3%)were diagnosed with fundus diseases by OCT and 57 eyes(20.5%)by OCT combined with ophthalmic B-type ultrasound. The positive rate of fundus disease detected by OCT had significant difference at the level of α=0.05 compared with those by ophthalmic B-type ultrasound, conventional ophthalmoscope and OCT combined with ophthalmic B-type ultrasound. CONCLUSION:OCT is more valuable and more sensitive on detecting macular diseases than the other two. However, the structure of retinal layer of the patients who had serious lens turbidity cannot be observed, which can be remedied by ophthalmic B-type ultrasound. The examination of OCT combined with ophthalmic B-type ultrasound is the most valuable one on accurate and early diagnosis of fundus diseases and the prediction of the visual acuity after surgeries.

Failure to identify a difficult airway can have serious consequences. It is essential that a thorough assessment of a patient's airway is made, including history and a focussed examination. It is known that the reliability of preoperative assessment is disappointing but positive findings will allow for an appropriate airway management plan to be devised in order to minimize airway-related complications. Despite this, situations will still occur where an unexpected difficult airway is encountered. [ABSTRACT FROM AUTHOR]

The retrospective analysis of 97 shoulder arthroplasties during 1998 to 2009 was performed. The hemiarthroplasty were fulfilled in 92 patients and total shoulder replacement in 5 patients. Total rate good and satisfactory results consists 32,0%, poor results - 68,0% (66 patients, include 5 patients with total shoulder arthroplasty). The lower level of good results was revealed in patients with chronic fractures and fracture-dislocations of shoulder. It related with changes bones of shoulder and muscles of shoulder (rotator cuff). In the studied group of patients there was no proper pre-operative diagnostics of the rotator cuff, articular surface of the scapula, which shows the need for careful preoperative examination to determine the indications for shoulder arthroplasty and select the type of prosthesis. Unsatisfactory results of total arthroplasty related to screw migration (in case of the transacromion approach) and to the development of subacromial impingement. The conclusion about the need to narrow the indications for use of the scapular component «Ortho-P». The authors showed preference to cemented implants without a metal base. It is necessary to introduce in practice the anatomic implants of the third generation allowing the fullest play the anatomy and biomechanics of the shoulder joint.

The present research provides analysis of results of preoperative examination of 680 patients with ectopic pregnancy depending on the range of surgical treatment. It has been shown that in case of progressive ectopic pregnancy the diagnostic significance of concentrations of human chorionic gonadotropin, transvaginal examination and laparos-copy depends on the duration of pregnancy. When the term of ectopic pregnancy is 3-4 weeks monitoring of p chorionic gonadotropin in blood serum (99.5%), transvaginal examination (58%) and laparoscopy (78.5%) are more informative. When the term of ectopic pregnancy is more than 4 weeks there is a high diagnostic value of monitoring p-subunit of chorionic gonadotropin (99.5%), transvaginal examination (68%) and laparoscopy (99,5%). The research has proved that pregnancy period of 3-4 weeks is optimal for laparoscopy and other operations