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Ukraine is among the countries with a high prevalence of acute chemical etiology poisoning in the countries of the European region, taking the penultimate place according to WHO (2017). The Aim of the Research. To study the risk factors for acute domestic poisoning among children and adolescents in Ukraine and to identify measures to improve it. Methods and Materials. The annual statistical reports of WHO, the data of the State Statistics Committee of Ukraine, the Center for Medical Statistics of the Ministry of Healthcare of Ukraine, and statistics of the Department of acute poisoning of the NCSH «Okhmatdyt» were analyzed. Research methods: system approach and benchmarking were applied. Results and Discussion. A comparative estimate of the incidence of acute poisoning over the last 15 years in Ukraine indicates an overall tendency for their growth as a whole: in the group of children 0–14 years, an average of 10.4% (from 13.8 ± 0.05 cases / 10000 in 1996–1998 to 15.4 ± 0.1 cases / 10000 pediatric population in 2006–2010). Among children aged 0–4 years, the rate of increase in the number of acute poisonings was the highest, i.e. it increased from 31.7 ± 0.1 to 37.1 ± 0.2 cases / 10000 of the pediatric population of this age. The incidence of primary diseases of the pediatric population, according to the data of the Injury and Poisoning statistical group, has been practically at the same level in recent years, with a slight upward trend. Thus, over the last 20 years the incidence has fluctuated within 39.6–51.4 cases / 10000 population. Conclusions. An important factor in the emergence of household poisoning is the lack of motivation of the population, including children and adolescents, to lead a healthy lifestyle (including maintaining a healthy diet). Key Words: chemical safety, food safety, toxicology, acute poisoning.

We report a case of an asymptomatic 40-year-old African American male who was referred to our clinic for evaluation of bilateral macular drusen. Medical history was remarkable only for diabetes mellitus type 1. Fundoscopy revealed a peculiar, bilateral pigmentary maculopathy. Further imaging included autofluorescence imaging that showed an irregular hypo- and hyperautofluorescent pattern consistent with severe retinal pigment epithelial (RPE) dysfunction. Optical coherence tomography supported outer retinal layer loss and RPE atrophy. Fluorescein angiography and electroretinography were also performed. Further discussion with the patient yielded a family history where 4 older siblings died in their teenage years from strokes and seizures. The patient was referred to a geneticist who ultimately diagnosed him with mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes syndrome, and genetic testing of his mitochondrial deoxyribonucleic acid identified an A3234G point mutation in the MT-TL1 gene.

Susac’s syndrome is microangiopathy defined by a triad of encephalopathy, sensorineural hearing loss, and multiple branch retinal artery occlusions. First case reports appeared in the literature in 1973 (Weidauer and Tenner 1973; Pfaffenbach and Hollenhorst 1973) and in 1979, Dr. John O. Susac published reports of microangiopathy of the brain and retina in two young women (Susac et al. 1979). Since first reported in the 1970s, approximately 300 case reports have been published on the disease. Susac’s syndrome most commonly affects young women and was initially only thought to affect females, however, it has been reported in males also. A recent systematic case review of all reported cases found a 3.5 to 1 female to male predominance and an average age of onset between 21 and 35 years (Dorr et al. 2013).

The authors report multimodal imaging including adaptive optics scanning laser ophthalmoscopy (AOSLO) (Apaeros retinal image system AOSLO prototype; Boston Micromachines Corporation, Boston, MA) in a case of previously diagnosed unilateral acute idiopathic maculopathy (UAIM) that demonstrated features of laser pointer maculopathy. The authors also show the adaptive optics images of a laser pointer maculopathy case previously reported. A 15-year-old girl was referred for the evaluation of a maculopathy suspected to be UAIM. The authors reviewed the patient's history and obtained fluorescein angiography, autofluorescence, optical coherence tomography, infrared reflectance, and AOSLO. The time course of disease and clinical examination did not fit with UAIM, but the linear pattern of lesions was suspicious for self-inflicted laser pointer injury. This was confirmed on subsequent questioning of the patient. The presence of linear lesions in the macula that are best highlighted with multimodal imaging techniques should alert the physician to the possibility of laser pointer injury. AOSLO further characterizes photoreceptor damage in this condition. [ Ophthalmic Surg Lasers Imaging Retina . 2016;47:782–785.]

PURPOSE To report two cases where the primary visual complaints were central visual phenomena, with normal fundus biomicroscopy. METHODS History and clinical examination, fundus autofluorescence, and spectral domain-optical coherence tomography. RESULTS The authors report 2 patients, a 66-year-old woman and a 77-year-old woman, who complained of a central visual disturbance in one eye. Best-corrected visual acuity was normal. Ophthalmoscopy in the first case was unremarkable and showed minimal retinal pigment epithelial mottling in Case 2. Spectral domain-optical coherence tomography revealed vitreomacular traction with foveal distortion in both eyes, associated with small cysts in the inner retinal layers and in one patient disruption of photoreceptors. CONCLUSION Central visual phenomena are important clues for central vitreomacular traction, even in the presence of a normal fundus examination. The authors highlight the importance of performing spectral domain-optical coherence tomography evaluation in this setting before considering neurologic or systemic causes.

Aim of work it was to conduct the analysis of frequency and testimonies to application of auxiliary technologies of экстракорпорального treatment of children with ARFof the different age–related groups.

The results of clinical and experimental study of the mechanisms underlying the antihypoxic effect of Acyzol are considered. Its effect on the acid-base balance of the blood and oxygen-transport properties of hemoglobin in patients with intoxication with hematotoxic poisons and hemic hypoxia are investigated. Its pharmacokinetic and physical effects on the heme and globin parts of hemoglobin of red blood cells had been studied. The conclusions about the mechanisms of antihypoxic action of Acyzol and prognosis regarding potentially effective its use in the treatment of somatic diseases and abnormalities were made., В статье приведены результаты клинического и экспериментального изучения механизмов, лежащих в основе антигипоксического действия препарата Ацизол. Исследовано его влияние на кислотно-основное состояние крови и кислородотранспортные свойства гемоглобина у пациентов с отравлениями гематотоксическими ядами и гемической гипоксией. Изучены его фармакокинетические и физические эффекты в отношении гемовой и глобиновой частей гемоглобина эритроцитов. Сделаны выводы о механизмах антигипоксического действия Ацизола и прогнозы в отношении потенциально эффективного его использования в лечении соматических заболеваний и патологических состояний., У статті наведені результати клінічного й експериментального вивчення механізмів, що лежать в основі антигіпоксичної дії препарату Ацизол. Досліджено його вплив на кислотно-основний стан крові і кисневотранспортні властивості гемоглобіну у пацієнтів з отруєннями гематотоксичними отрутами й гемічною гіпоксією. Вивчені фармакокінетичні й фізичні ефекти препарату щодо гемової і глобінової складових гемоглобіну еритроцитів. Зроблені висновки про механізми антигіпоксичної дії Ацизолу і прогнози стосовно потенційно ефективного його використання в лікуванні соматичних захворювань і патологічних станів.

BACKGROUND/PURPOSE To report an unusual appearance of severe bilateral serous detachments in a patient with Waldenstrom macroglobulinemia. METHODS A case report of a Fifty-six-year-old female patient with Waldenstrom macroglobulinemia. RESULTS A patient with Waldenstrom macroglobulinemia presented with serous retinal detachments at the time of diagnosis with Waldenstrom. The patient's IgM levels remained abnormally elevated in the initial stages of her disease course, leading to dramatic ocular findings and images on optical coherence tomography. Chemotherapy was initiated and IgM levels slowly declined, with some improvement in macular fluid as IgM normalized. CONCLUSION Waldenstrom macroglobulinemia may lead to dramatic retinal pathology if IgM levels remain elevated. Prompt chemotherapy and reduction of immunoglobulin levels should be undertaken to preserve retinal architecture.

Purpose: To report a case of presumed gemcitabine-induced retinopathy and nephropathy. Methods: Case Report. Retrospective chart review. Results: A 64-year-old woman with a recent diagnosis of metastatic cholangiocarcinoma presented with progressive visual loss and renal failure shortly after the initiation of a chemotherapy regimen which included gemcitabine. Clinical examination and fluorescein angiography showed findings of severe retinal ischemia. Conclusion: Although gemcitabine chemotherapy has been reported to cause a Purtscher-like retinopathy, we propose in our patient a gemcitabine-induced vasculopathy that lead to significant retinal and renal ischemia.

The article deals with findings of the studies on the efficiency of treatment for acute poisoning with chlorpyrifos in a young child. We studied the efficiency of multicomponent intensive therapy with antidotal drugs. Conclusions about the efficiency of antidote therapy scheme use were made., В статье приведены результаты исследования эффективности лечения острого отравления хлорпирифосом у ребенка младшей возрастной группы. Исследована эффективность многокомпонентной интенсивной терапии с включением антидотных препаратов. Сделаны выводы относительно эффективности использования схемы антидотной терапии., У статті наведені результати дослідження ефективності лікування гострого отруєння хлорпірифосом у дитини молодшої вікової групи. Досліджено ефективність багатокомпонентної інтенсивної терапії із включенням антидотних препаратів. Зроблено висновки щодо ефективності використання схеми антидотної терапії.

MEK inhibitor chemotherapy, used in various malignancies, has been reported to be associated with serous retinal detachments. This study reports serial multimodal imaging focused primarily on infrared reflectance and spectral-domain optical coherence tomography (SD-OCT) in the monitoring of MEK inhibitor retinal toxicity. The benefit of OCT angiography in understanding the pathophysiology of MEK inhibitor toxicity is also shown. [ Ocular Surg Lasers Imaging Retina . 2016;47:76–77.]

Zulfitri A Mat Daud,1 Boniface Tubie,2 Marina Sheyman,2 Robert Osia,2 Judy Adams,2 Sharon Tubie,2 Pramod Khosla1 1Department of Nutrition and Food Science, Wayne State University, Detroit, MI, USA; 2Great Lake Dialysis Clinic, LLC, Detroit, MI, USA Purpose: Chronic hemodialysis patients experience accelerated atherosclerosis contributed to by dyslipidemia, inflammation, and an impaired antioxidant system. Vitamin E tocotrienols possess anti-inflammatory and antioxidant properties. However, the impact of dietary intervention with Vitamin E tocotrienols is unknown in this population. Patients and methods: A randomized, double-blind, placebo-controlled, parallel trial was conducted in 81 patients undergoing chronic hemodialysis. Subjects were provided daily with capsules containing either vitamin E tocotrienol-rich fraction (TRF) (180 mg tocotrienols, 40 mg tocopherols) or placebo (0.48 mg tocotrienols, 0.88 mg tocopherols). Endpoints included measurements of inflammatory markers (C-reactive protein and interleukin 6), oxidative status (total antioxidant power and malondialdehyde), lipid profiles (plasma total cholesterol, triacylglycerols, and high-density lipoprotein cholesterol), as well as cholesteryl-ester transfer protein activity and apolipoprotein A1. Results: TRF supplementation did not impact any nutritional, inflammatory, or oxidative status biomarkers over time when compared with the baseline within the group (one-way repeated measures analysis of variance) or when compared with the placebo group at a particular time point (independent t-test). However, the TRF supplemented group showed improvement in lipid profiles after 12 and 16 weeks of intervention when compared with placebo at the respective time points. Normalized plasma triacylglycerols (cf baseline) in the TRF group were reduced by 33 mg/dL (P=0.032) and 36 mg/dL (P=0.072) after 12 and 16 weeks of intervention but no significant improvement was seen in the placebo group. Similarly, normalized plasma high-density lipoprotein cholesterol was higher (P

Importance Our experience may be useful to other practitioners using compounded intravitreal agents, those suspecting infectious outbreaks, and those managing fungal endophthalmitis. Objective To describe a series of patients with fungal endophthalmitis following intravitreal injection of combined bevacizumab and triamcinolone acetonide prepared by the same compounding pharmacy. Design and Setting Noncomparative case series. Participants Eight eyes of 8 patients who received an intravitreal injection of compounded combined bevacizumab-triamcinolone in a period of 3 weeks had subtle, nonspecific findings that were later diagnosed as fungal endophthalmitis. Main Outcome Measures Visual acuity, response to antimicrobial therapy, and number of vitreoretinal surgical operations after diagnosis of fungal endophthalmitis. Results Eight patients developed endophthalmitis 41 to 97 days after receiving the intravitreal injection, which was prepared by the same compounding pharmacy. The injections occurred at the same location in New York. Treatment was based on clinical examination findings and knowledge of the etiology of the endophthalmitis. Eventually, all patients were treated with oral voriconazole. Five of 8 patients were initially treated with intravitreal antimicrobial agents. After 3 months of follow-up, visual acuities ranged from 20/50 to hand motions. Local, state, and federal health department officials were involved in investigating the source of the outbreak. Conclusions and Relevance In the current study, we report a fungal endophthalmitis outbreak after intravitreal injection of contaminated, compounded combined bevacizumab-triamcinolone. In this series, Bipolaris hawaiiensis was the identified causative agent. The challenge of medical diagnosis, identification of the source of the outbreak, and management experience are highlighted in our series. Our experience may be useful to other practitioners using compounded intravitreal agents, those suspecting infectious outbreaks, and those managing fungal endophthalmitis.

Karen B Fernandez, Seth P Epstein, Geoffrey S Raynor, Alan T Sheyman, Morgan L Massingale, Peter G Dentone, Lukas D Landegger, Penny A Asbell Department of Ophthalmology, Mount Sinai School of Medicine, New York, NY, USA Purpose: To determine the changes in dry eye disease (DED) severity and the percentage of cells expressing HLA-DR on the ocular surface following treatment with lubricant eyedrops containing polyethylene glycol and propylene glycol (PEG/PG) and the gelling agent hydroxypropyl guar (HP-Guar).Patients and methods: Nineteen patients with DED used PEG/PG + HP-Guar eyedrops four times per day for 30days. Assessments included DED severity (Ocular Surface Disease Index [OSDI], corneal staining, conjunctival staining, tear film break-up time [TFBUT], and Schirmer testing) and impression cytology of the conjunctiva with masked flow cytometry at baseline and at 30days.Results: There was a significant decrease in corneal staining (P

Intervention to correct malnutrition and chronic inflammation in dialysis patients is often impeded by poor compliance due to medical and socioeconomic barriers. Therefore we performed a pilot study to investigate the technical feasibility of “directly observed treatment” of nutritional supplementation (protein and omega-3 fatty acids) and its effects on nutritional and inflammatory markers in low socio-economic status hemodialysis population. Sixty-three eligible patients agreed to participate. Two intervention groups received 30 mL of a liquid protein supplement plus either 2.4 gm omega-3 (1.8 gm eicosapentaenoic acid + 0.6 gm docosahexaenoic acid) or a placebo, three times per week after their routine dialysis session for 6 months. Serum albumin, plasma lipids, and other indicators of nutritional and inflammatory status were measured. Statistical differences after treatment and between groups were determined using paired t-test and independent t-test, respectively. Directly observed nutritional supplementation resulted in a significant improvement in the LDLC/HDLC ratio in the omega-3 group as compared to the placebo group (P = 0.043). For the omega-3 group, serum albumin was also marginally higher after 6 months as compared to baseline (P = 0.07). Other nutritional and inflammatory markers were unaffected by intervention. In conclusion, “Directly observed treatment” is technically feasible with an omega-3 based supplement (as opposed to a pure protein supplement) showed beneficial effects on the lipid profile.