RESUMEN
OBJECTIVE: To evaluate the effectiveness of prevention of recurrent laryngeal nerve injury depending on thyroid gland lesion and extent of surgery. MATERIAL AND METHODS: There were 2412 thyroid surgeries between 2000 and 2020. Patients were divided into the main group (1689 patients) and the control group (729 patients). Patients with nodular thyroid gland lesions prevailed in both groups (987 (58.4%) and 415 (56.9%), respectively). All ones underwent atraumatic extrafascial desection and thyroid resection (ultrasonic scalpel). RESULTS. T: He upper laryngeal nerve injury occurred in 35 cases (1.4%). The number of surgeries with thyroid remnant preservation was significantly lower in the main group. The number of procedures with subtotal thyroid resection and thyroidectomy increased by 2.4 times (from 414 to 1010 operations, p<0.05). CONCLUSION: Improvement of surgical treatment of thyroid gland lesions consisting in new operative technique of recurrent laryngeal nerve isolation using ultrasonic scalpel reduces the incidence of recurrent laryngeal nerve injury from 2.3% to 1%. At the same time, the number of extended procedures in the main group significantly exceeded that in the control group (by 2.5 times).
Asunto(s)
Traumatismos del Nervio Laríngeo Recurrente , Glándula Tiroides , Tiroidectomía , Humanos , Traumatismos del Nervio Laríngeo Recurrente/prevención & control , Traumatismos del Nervio Laríngeo Recurrente/etiología , Masculino , Tiroidectomía/métodos , Tiroidectomía/efectos adversos , Femenino , Persona de Mediana Edad , Adulto , Glándula Tiroides/cirugía , Complicaciones Posoperatorias/prevención & control , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/epidemiología , Enfermedades de la Tiroides/cirugía , Federación de Rusia/epidemiologíaAsunto(s)
Pruebas de Visión/métodos , Agudeza Visual , Adulto , Factores de Edad , Conducción de Automóvil , Humanos , Masculino , Persona de Mediana Edad , OcupacionesRESUMEN
Visual acuity in healthy drivers depends directly on illumination of test objects. This acuity increases with better light conditions in 20-30 years of age, whereas in 35-50 year-olds no significant increase is seen. Lower visual acuity is expected with worse light conditions and vice versa - maximal visual acuity with better illumination.
Asunto(s)
Adaptación Ocular/fisiología , Conducción de Automóvil , Iluminación , Agudeza Visual/fisiología , Adulto , Humanos , Masculino , Persona de Mediana Edad , Salud Laboral , Valores de ReferenciaRESUMEN
When optotypes' contrast changes, one can see reliable difference with optotypes presentation on gray and dark gray background. Light gray background does not influence visual functions, there was no reliable difference. Authors point out possible forecasting of visual acuity decrease with optotypes' contrast changes--that is extremely important for occupational selection of automobile drivers, as dark gray background is major in dusty rainy weather when objects and traffic signs are hardly distinguishable.
Asunto(s)
Sensibilidad de Contraste/fisiología , Adaptación a la Oscuridad/fisiología , Vehículos a Motor , Agudeza Visual/fisiología , Adulto , Humanos , Masculino , Exposición Profesional , Estimulación Luminosa , Pronóstico , Valores de ReferenciaRESUMEN
Peculiarities of drivers' work require visual strain. The studies prove considerable changes in accommodation (value of absolute and resources of relative accommodation), muscular balance, visual performance in correction test, that prove visual fatigue of automobile drivers, especially aged 20 to 30.