[Advances in preservative-free glaucoma drops].

Ophthalmic solutions are the main therapeutic methods used in the treatment of ocular diseases, including glaucoma. Preservatives are added in multidose solutions to reduce the risk of microbial contamination. Repeated use of topical medication, especially in patients treated for glaucoma, has many adverse effects especially on the ocular surface.

[Emergency pancreatoduodenectomy for severe iatrogenic duodenal injury--case report].

We present the case of a male patient admitted for high flow biliary fistula (> 2000 ml/24h) as a consequence of a prior right nephrectomy by lumbar approach. The patient was operated after the failure of the medical conservative treatment and continous declining medical status. We noted the complete absence of the gastric antrum, duodenum I and II with the intraperitomeal direct display and opening of the Vater papilla, witch was difficult to identify unless common bile duct (CBD) was catheterized by supraduodenal choledocotomy.

[Gastric metastasis of clear cell renal carcinoma].

We report the case of a patient operated in 2003 for renal clear cell carcinoma (CCRC), when left nephrectomy was performed. In the years following occur: lung (2004) and brain (2006) metastasis, pathological bone fracture in right femur (2007), which needed a complex treatment: polichimiotherapy, cobaltotherapy, right temporal metastasectomy, right femoral fixation with metal rod. In our clinic was hospitalised for serious upper gastrointestinal bleeding, severe anaemia (haemoglobin 5.

[Laparoscopic ultrasound in biliary diseases].

Laparoscopic ultrasound is an intraoperative exploration of the abdominal viscera using ultrasounds. The aim of this work is to obviate this new method of exploration and to underline its advantages and limits. In this study were enroled 65 pacients with gallbladder stones, admitted in The Surgical Clinic, "Elias" Emergency Hospital, from October 2005 until December 2006.

[About ocular surface damage].

Tear film maintain ocular surface health and functional through nutritional support, anti-bacterial properties, viscoelastic protection, smooth optical surface and increase of lubrication. The ocular surface may be affected after surgery (cataract, glaucoma, refractive surgery) or chronic glaucoma treatment.

[Increased ocular perfusion--visual field preservation].

Adjustment of the ocular flow has clear implications in glaucomatous pathology. It cannot be drawn a clear barrier between causality and effect of ocular vascular factor in glaucoma but altered hemodynamics leads clearly to node loss. Unstable ocular perfusion creates a low blood flow to the optic nerve directly involved in glaucomatous optic neuropathy , ocular perfusion pressure (PPO) being a risk factor predictor of progression associated with impairment of visual function in glaucoma.

[Glaucoma and ocular surface].

Topical eye-drops remain the cornerstone of treatment for ocular diseases, including glaucoma. Preservatives are added to multi-dose medication bottles to reduce the risk of microbial contamination, to extend the validity of the product and to allow an easily use of the bottles. However the repetitious use of ophthalmic medications containing preservatives, particularly when treating chronic diseases, has been linked to adverse effects and ocular surface disease (OSD).

[Surgical management of Meckel's diverticulum in adults--retrospective analyses of 62 cases].

Meckel's diverticulum (MD) is the most common congenital anomaly of the small intestine. We searched and analyzed the records of 62 cases with MD admitted in University Emergency Hospital Bucharest between 2001-2009. Sex ratio was M:F 3:1, with 74% male and 26% female.

[Intravitreal triamcinolone acetonide treatment in diabetic macular edema].

Purpose: To assess the efficacy and safety of intravitreal triamcinolone acetonide in diabetic macular oedema.

Methods: prospective study; 76 patients, 102 eyes; preoperative assessment: visual acuity, intraocular pressure, fundus biomicroscopy fluoresceine angiography, sometimes OCT; postoperative assessment: visual acuity, intraocular pressure, fundus biomicroscopy, fluoresceine angiography, sometimes OCT.

Results: Visual acuity improvement in 42% cases; subjective improvement of visual acuity in 72% of cases

Conclusions: Triamcinolon acetonide may play a role in treatment of diabetic macular oedema.

[Rhegmatogenous retinal detachment--clinical case].

We present the case of a 57 years old woman which was admitted for the amputation of the infero-nasal visual field of the right eye, change observed by the pacient for 2 weeks. Clinical examination and lab exams revealed the cause of this change: a rhegmatogenous retinal detachment in the superior temporal quadrant. Surgical treatement was warranted.

[Panuveitis--difficulties in diagnosis and treatment].

We report the case of a young patient who had a past history of HSV encefalitis and presented for decreased vision in her left eye associated with pain and red eye.

[Perimetric changes in advanced glaucoma].

Aim: The evaluation of various perimetric aspects in advanced glaucoma stages correlated to morpho-functional changes. MATHERIAL AND METHOD: Retrospective clinical trial over a 10 months time period that included patients with advanced glaucoma stages, for which there have been recorded several computerised visual field tests (central 24-2 strategy, 10-2 strategy with either III or V--Goldman stimulus spot size) along with other morpho-funtional ocular paramaters: VA, lOP optic disk analysis.

Results: We included in our study 56 eyes from 45 patients.

[Progresses in antiinflamatory treatment in cataract surgery].

Anti-inflamatory medication is commonly used to reduce inflammation, edema and symptoms associated with allergies, trauma and infections diseases. Topical nonsteroidial anti-inflammatory (NSAIDs) and topical corticosteroids are overview of the role of topical NSAIDs and the progress of their use in eye surgery

[Fixed combination of topical prostaglandin analogue in glaucoma treatment].

The purpose of glaucoma treatment is to prevent progressive loss of optic nerve fibers and thereby to preserve the visual field. Because increased IOP is a primary risk factor in developing glaucoma, descrease its value below which may affect the optic is the antiglaucoma treatment target. This paper provides an overview of glaucoma treatment and the use of fixed combinations of topical prostaglandin analogues (PGA).

[The role of laparoscopy in the surgical treatment of scleroatrophic cholecystitis].

Atrophic cholecystitis is a chronic inflammatory complication of biliary lithiasis which occurs after many years of evolution and causes many problems in the surgical therapy. Authors analyze a 39 patients cohort and present the difficulties encountered during the treatment, especially in laparoscopic approach. These particular difficulties lead to a increase in conversion rate, 11.

[The secret of red eyes].

"Red eye" is a sign and the same time a symptom frequently met in the ophthalmological practice. The "red eye" is not always the clinical manifestation of a common conjunctivitis. We will present a case report of a patient who accused conjunctival hyperemia, lacrimation, foreign--body sensation; she was also describing recurrent conjunctivitis for the past year.

[Duodenal carcinoid].

Carcinoid tumors of the duodenum are extremely rare. We present two cases (observation) of duodenal carcinoid tumors. The main clinical manifestation in both cases was upper GI tract hemorrhage associated to severe anemia.

[Porcelain gallbladder--diagnostic and therapeutic features].

Porcelain gallbladder (PG) is a rare entity. It's frequently associated with cholecyst lithiasis (90%). Diagnosis is established based on imaging assays (simple abdominal radiography, ultrasound and/or abdominal CT).

[Assessment of a patient with optic neuropathy].

Optic neuropathy (ON) is defined as the reduction of vision due to inflammatory lesion of the optic nerve. The patient with ON has to be evaluated clinically but also with complex techniques (magnetic resonance imaging, visual evoked potentials, cerebrospinal fluid examination) because ON could be the presenting symptom in multiple sclerosis patients. Corticosteroids should be administrated intravenous and the patient should be followed by the neurologist in order to signal the appearance of new neurological signs.

[Periampullar diverticulum--related to bilio-pancreatic disorders].

Unlabelled: Periampullar diverticulum (PAD) represent a particular type of duodenal diverticulum, with important pathological effect on the functionality of both the billiary tree and the pancreas. In our retrospective, randomised study, we analised 204 patients who underwent ERCP. We diagnosed 34 PAD (17%).

[Postoperative hypoparathyroidism, an assumed risk in total thyroidectomy for Graves disease].

Hypocalcemia is a common clinical occurrence and has many potential causes, one of which can be congenital or acquired hypoparathyroidism. Acquired hypoparathyroidism is most commonly the result of damage to the glands, usually to their blood supply, during thyroidectomy, parathyroidectomy, or radical neck dissection. We present the case of a 40-year-old female known with Waldenström macroglobulinemia, cronic hepatitis C, who has been diagnosed with Graves disease and associated ophtalmopathy in 2004 and treated with antithyroid drugs for 1.

[Complicated Meckel's diverticulum in adult pathology].

Meckel's diverticulum is the most prevalent abnormality of the gastrointestinal tract seen in approximately 2% of the population. Diagnosing complicated diverticulum is difficult, for its capacity to mime multiple disorders such as appendicitis, ulcer disease, enterocolitis, Chron disease, sigmoid diverticulitis, cholecystitis, and it should be considered in all patients with unexplained chronic abdominal pain, nausea, vomiting, gastrointestinal bleeding, unexpected cause of intestinal obstruction or acute abdomen. Herewith we provide an illustrative presentation, emphasizing the difficulties in preoperative diagnosis of complicated Meckel's diverticulum and underlining the nonspecific nature of the subjective and objective findings.

[Long-term follow up after surgery for intractable ascites].

Unlabelled: The aim of the study is to evaluate the outcome of a selected group of 24 patients who underwent surgery for refractory ascites, in a 10 years period, 1995-2005.

Clinical Diagnosis: Alcoholic cirrhosis (n=18), inferior cava thrombosis (n=2), splenic vein thrombosis (n=1), cryptogenic cirrhosis (n=3), with association of variceal bleeding and refractory ascites. The surgical procedures consisted of porto-sistemic shunts (n=12), peritoneo-saphene shunts (n=10), mesenterico-caval shunt (n=1), mesenterico-right atrium shunt (n=1).

[Refractive stability of artificial crystallins--acrysof TORIC].

Purpose: To evaluate the results of AcrySof Toric intraocular lens (Alcon) implantation to correct pre-existing astigmatism and rotational stability in patients having cataract surgery or not.

Methods: Retrospective study three surgical teams, between February 2009-August 2010, included 37 eyes with more than 1 diopter (D) of preexisting corneal astigmatism having or not cataract surgery.

Results: Rotation at 6 M post-op: 32 patients (87%)--> rotation between aprox.

[Cornea in glaucoma].

The authors present a clinical, observational, retrospective, randomized study, performed between 06.01-01.05.