Saratov JOURNAL of Medical and Scientific Research

Virsta A.M.

Saratov State Medical University n.a. V.I. Razumovsky Department of Eye Diseases, Post-graduate

Development of ophthalmic training simulator for cataract surgery

Year: 2017, volume 13 Issue: №2 Pages: 417-420
Heading: Ophtalmology Article type: Original article
Authors: Kumova S.V., Lunev I.A., Gasparyan E.A., Virsta A.M., Batishcheva Yu.S., Kamenskikh T.G., Dolinina O.N.
Organization: Saratov State Medical University, Saratov state university, Yuri Gagarin State Technical University of Saratov
Summary:

Purpose: development of interactive simulator for the development of phacoemulsification. Material and Methods. Material and methods: the Software developed by the authors ophthalmic virtual simulator has several modules that can also be complemented by depending on put before the students the task. Testing the virtual simulator "Phacoemulsification" held at the Department of ophthalmology with the participation of 20 interns and 18 residents. Results. The development of residents and interns of ophthalmological profile of the theoretical foundations of cataract surgery using developed by the authors of the publication virtual interactive simulator demonstrated the effectiveness of this technique in comparison with passive viewing of video recording operations and the familiarity with the course of phacoemulsification in the operating room. Conclusion. The application of the developed simulator with the purpose of optimization of educational process of residents and interns of ophthalmic profile is a very effective tool in the world today.

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Fluorescent angiography and optical coherence tomography with angiography of the ocular fundus in patients with "the wet" form of an age-related macular degeneration.

Year: 2017, volume 13 Issue: №2 Pages: 345-349
Heading: Ophtalmology Article type: Original article
Authors: Virsta A.M., Kamenskikh T.G., Nugaeva N.R., Kolbenev I.O., Gileva E/V.
Organization: Saratov State Medical University
Summary:

Purpose: to investigate the informative value of fluorescent angiography (FA) and optical coherence tomography with fundus angiography (angio-OCT) in the diagnosis of "wet" form of age-related macular degeneration (AMD). Material and methods. The present study included 20 patients (20 eyes) diagnosed with degeneration of macula and posterior pole of the eye, the "wet" form (late stage age-related macular degeneration, AREDS category 4). The study used machines: optical coherence tomography, Spectralis HRA+OCT (Heidelberg Engeneering, Germany), optical со- herence tomography-angiography CIRRUS HD-OCT MODEL 5000 (Carl Zeiss, Germany). Results. When conducting the FA, in 11 patients found the ill-defined zone of small leakage of dye in 7 patients revealed a clearly defined area of hyperfluorescence in the early phase, and marked leakage of dye in the late phase, 2 patients — uncertain indices. In connection with the received data questionable PHAGE in 11 patients, all were held angio-OCT, to clarify the localization of choroidal neovascularization (CNV). When performing angio-OCT in 11 patients revealed that "wet" form of AMD with occult choroidal neovascularization. In 7 patients there had been discovered classic CNV in 2 patients combined. Conclusion. Angio-OCT gives a clearer picture about the presence of a choroidal neovascular membrane that plays a significant role in determining the course of treatment of patients with wet age-related macular degeneration.

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Anaesthesiological maintenance in total endo-prosthesis of large joints

Year: 2013, volume 9 Issue: №2 Pages: 241-246
Heading: Anaesthesiology and Reanimatology Article type: Original article
Authors: Prigorodov М.V., Pominova I.V., Noskova I.L, Tashkaev I.V., Virsta A.M.
Organization: Clinical hospital n.a. S. R. Mirotvortsev SSMU, Saratov State Medical University
Summary:

Purpose: To improve the quality of anesthetic protection in prosthetics of large joints based on a steady state energy balance. Materials and methods: Prospective, randomized study on the basis of a controlled hemodilution (CM) double mask has been performed. In the first group of patients (32-19 women) hemodilution (HS) has not been done. The second group of patients (31-17) consisted of patients with HS. Three phases of the survey have been selected — before surgery, traumatic phase of the operation, after the operation. Analyzed the parameters of central hemodynamics (Cl (I/ min/m2) and total peripheral vascular resistance TPVR (dyn * sec1 * cm5), gas exchange (DO (ml / min) and V02 (ml / min), energy metabolism (kcal / min; kcal / day). For data processing statistical package STATISTICA6,0 was used. Results: Central hemodynamic parameters in both groups did not significantly change, and did not differ between the groups. A significant reduction in D02. DO differences between groups of patients at all stages of the studies found has been determined in both groups of patients. Oxygen consumption in the first group of patients decreased significantly to traumatic phase of the operation, and the next stage rose to baseline. Oxygen consumption in the group with CM increased by traumatic phase of the operation, but then returned to baseline. In patients with CM oxygen consumption was significantly higher than in patients without CM at all time points. It is found that there is a significant drop in energy metabolism in the first group of patients in traumatic phase of the operation, followed by reduction of the energy poten-
tial. It is noted that insignificant increase of energy on stage traumatic operation in the second group of patients, with a subsequent decrease to the original level. Energy exchange at all stages of the study was significantly higher in the second group of patients. Logistic regression analysis found that controlled hemodilution is associated with increased energy metabolism at the stage prior to surgery for traumatic stage and after the intervention. Conclusion: It has been established a connection with the growth of energy controlled hemodilution with radical intervention on the hip joint. Substantial energy deficit in patients without HS on traumatic phase of the operation reveals that the high probability of occurrence of cardiovascular complications.

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Influence of anaesthesia on energy metabolism in surgery

Year: 2013, volume 9 Issue: №1 Pages: 47-49
Heading: Anaesthesiology and Reanimatology Article type: Original article
Authors: Prigorodov М.V., Tashkaev I.V., Pominova I.V., Noskova I.L, virsta A.M.
Organization: Clinical hospital n.a. S. R. Mirotvortsev SSMU, Saratov State Medical University
Summary:

The purpose of the article is to establish adequacy of protection of energy metabolism in a patient under anaes-thesiology in cholecystectomy from mini-access. Material et methods: 122 patients subjected to cholecystectomy from mini access have been surveyed. Among them 92 patients have got intravenous general anaesthesia with AVL, 30 patients have got prolonged epidural anaesthesia on spontaneous breath with insufflations of oxygen through an obverse mask with sedatations. Monitoring of energy-plastic metabolism has been carried out in all patients. Results: Groups of patients have been compared by anthropometrical data, traumatic interventions. In both groups of patients loss of energy to traumatic to an operation stage has insignificantly increased, but after the anaesthesia termination in the group of patients with intravenous anaesthesia loss of energy continued to rise, and in the group of patients with prolonged epidural blockade it has returned to the initial level. After the anaesthesia termination the energy metabolism became essential higher in the first group of patients in comparison with the second one (p

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