Computed tomographic signs of extraocular muscle changes in endocrine ophthalmopathy

The paper presents the results of a computed tomographic study of extraocular muscles (EOM) in 75 patients (131 orbits) without orbital pathology and different forms of endocrine ophthalmopathology. It also gives data on changes in EOM density and structure. The outline of the muscles has been studied at different stages of edematous exophthalmos and endocrine myopathy. The obtained quantitative results of EOM changes allow one to make a differential diagnosis of different forms of endocrine ophthalmopathy and to plan treatment of these patients.     

Economic burden of rotavirus disease in children under 5 years in Kazakhstan

Background

We aimed to estimate the societal costs of rotavirus cases among children less than 5 years in Kazakhstan, an upper-middle income country in Central Asia.

Methods

Data on medical, non-medical and indirect costs were collected for 190 patients less than 5 years, hospitalized with severe diarrhea in 2009 in two pediatric hospitals. Data on resource use for moderate and mild diarrhea cases were obtained from published sources. A probabilistic sensitivity analysis was performed to explore uncertainty in cost estimates.

Results

Approximately 4,000 severe, 30,700 moderate, and 122,900 mild rotavirus cases were estimated annually in children <5 years old. The mean societal cost of a severe, moderate and mild rotavirus case was estimated at US$ 454, 82, and 21, respectively. The total annual cost of rotavirus disease was $37.53 million or on average $107.36 for a child under 5 years old in Kazakhstan. Ninety-four percent of total costs (35.13 million) are indirect costs (productivity losses) from fatal cases and parents’ job absenteeism, while direct medical costs account for 2.04 million (5.4%), and direct non-medical for 0.46 million (1.2%).

Conclusions

Rotavirus-associated diarrhea represents a significant economic burden in Kazakhstan, largely due to indirect costs. The costs of rotavirus infections should be considered when planning further preventive actions, including the introduction of rotavirus vaccination.     

Lipogenic type of edematous exophthalmos: clinical picture, treatment

The authors describe the clinical picture and course of the lipogenic type of edematous exophthalmos. Internal orbital decompression is proposed to use as an alternative technique in the treatment of the lipogenic type of edematous exophthalmos.     

MAO A knockout attenuates adrenocortical response to various kinds of stress

The effect of a lack of the gene encoding monoamine oxidase A (MAO A) in transgenic Tg 8 mice on the corticosterone response to restraint, cold, water deprivation-induced, or social acute stress as well as chronic variable stress was studied. It was found that Tg 8 mice with genetic MAO A knockout and wild-type C3H/HeJ (C3H) strain showed similar plasma corticosterone resting level. MAO A knockout mice differed from C3H mice by attenuated response to restraint (60 min), cold (4 degrees C, 60 min), and water deprivation (48 h) as well as to a chronic (15 days) variable stress. No difference between Tg 8 and C3H strains in the response to psychosocial stress (encounters for 30 min of six previously isolated mice) has been found. ACTH administration to dexamethasone-pretreated mice produced a similar corticosterone effect in Tg 8 and C3H mice, indicating that the decreased stress response in MAO A-deficient mice was due rather to the central mechanisms regulating stress-induced ACTH release than to adrenocortical responsiveness to ACTH.     

Internal orbital decompression in uncompensated edematous exophthalmos

The efficiency of internal orbital decompression was evaluated in uncompensated edematous exophthalmos (EE). Twenty-two patients aged 17-65 years who had EE (30 orbits) were followed up. EE in a subcompensation and decompensation stage occurred in 12 (17 orbits) and 10 (13 orbits) patients, respectively. When glucocorticoid therapy was ineffective, internal orbital decompression was made in order to preserve visual functions. Surgery was performed via transconjunctival approach (Brovkina, 2004). After surgery, exophthalmos diminished by an average of 4.6 and 5.6 mm in a subcompensation and decompensation stage, respectively. There was a substantial reduction in periorbital tissue edema, in conjunctival changes, corneal opacity, and optical neuropathy to the extent of complete regression. Internal orbital decompression is effective in uncompensated forms of EE, as appeared as a significant alleviation of its clinical symptoms and as preserved or increased baseline visual acuity.     

Congenital pathology of the eye as a main cause of impaired vision in children

Congenital diseases of the eyes is the most frequent cause of vision reduction in children and one of the major causes of invalidity for poor sight. The aim of the present study was analysis of the causes of congenital ocular diseases in children in Kazakhstan. Results of prophylactic examinations at some rural districts of the republic evidence that refraction abnormalities rank first in the structure of congenital ocular diseases, oculomotor system abnormalities second, and defects of the eyelids and lacrimal tract, third. Congenital diseases of the eye make up 29-42 percent of all ocular diseases in children. Hospital records evidence a 45 percent incidence of congenital diseases of the eye. Lenticular abnormalities rank first, oculomotor system pathology second, and eyelid diseases third in the structure of congenital diseases of the eyes.