Vasconcelos-Santos, Daniel Vitor; Machado Azevedo, Danuza O; Campos, Wesley R; Oréfice, Fernando; Queiroz-Andrade, Gláucia M; Carellos, Ericka V Machado; Castro Romanelli, Roberta M; Januário, José Nelio; Resende, Luciana Macedo; Martins-Filho, Olindo Assis; de Aguiar Vasconcelos Carneiro, Ana Carolina; Almeida Vitor, Ricardo W; Caiaffa, Waleska Teixeira
To report results of early ophthalmologic examinations in a large cohort of newborns with congenital toxoplasmosis (CT) after neonatal screening. Cross-sectional analysis of a cohort. A total of 178 newborns with confirmed CT from 146,307 screened babies (95% of live births) from Minas Gerais state, southeastern Brazil. From November 2006 to May 2007, newborns underwent neonatal screening by immunoglobulin (Ig)M capture of dried blood samples. On all positive or suspected cases, confirmative serology was performed on babies and their mothers. Congenital toxoplasmosis was confirmed in newborns who had IgM and/or IgA and IgG, or IgG associated with suggestive ocular lesions (with IgM and IgG in the mother). Ophthalmologic evaluation consisted of indirect ophthalmoscopy with a lid speculum. Pediatric examination and radiologic studies of the central nervous system were also performed. In selected cases, biomicroscopy of the anterior segment, fundus photographs, or ultrasonography (B-scan) was performed. Prevalence of retinochoroidal lesions, either cicatricial or active, and their location and associated findings, such as vascular sheathing, hemorrhage, vitreous opacities, and retinal detachment, were evaluated. The occurrence of cataract, microphthalmia, microcephaly, intracranial calcification, and hydrocephalus was also recorded. Of 146,307 neonates screened, 190 had CT, yielding a prevalence of 1 in 770 live births, of whom 178 (93.7%) underwent standardized ophthalmologic examination at an average age of 55.6+/-16.6 days. Of these 178 infants, 142 (79.8%) had retinochoroidal lesions consistent with CT in at least 1 eye. Bilateral involvement was noted in 113 patients (63.5%). Macular involvement was seen in 165 eyes (46.3%) of 111 patients (62.4%). Active lesions were observed in 142 eyes (39.9%) of 85 patients (47.8%). These lesions were located in the macula of 75 eyes (21.1%) and were associated with retinal vascular sheathing in 44 eyes (12.4%). A high
Rucker, Janet C; Kennard, Christopher; Leigh, R John
The neuro-ophthalmological examination constitutes one of the most refined and exact components of the clinical examination, often allowing precise diagnosis and formulation of a treatment plan even within the compass of the first visit. This chapter briefly highlights important features in the neuro-ophthalmological history and then presents detailed information on the important components of a comprehensive neuro-ophthalmological examination. Covered examination topics include visual acuity, visual field testing, color vision, external eye exam, pupils, ophthalmoscopy, and eye movements. The final section discusses ancillary tests that supplement the bedside neuro-ophthalmological examination, including formal visual field analysis, electroretinography, fluorescein angiography, ocular coherence tomography, visual-evoked potentials, neuroimaging, and quantitative eye movement recordings. Copyright © 2011 Elsevier B.V. All rights reserved.
Joshi, L; Shanmuganathan, V A; Kneebone, R L; Amoaku, W
Aims Cognitive factors (eg, academic achievement) have had a significant role in selecting postgraduate surgical trainees in the past. This project sought to determine the role of a national undergraduate ophthalmology prize examination (Duke–Elder examination) in the selection of postgraduate ophthalmology trainees. This would also serve as a quality assurance exercise for the assessment, in which the ultimate aim is to encourage trainees into ophthalmology. Methods A retrospective analysis of the top 20 ranked candidates in the Duke–Elder examination from 1989 to 2005 (except 1995) was carried out to determine which of them subsequently entered the ophthalmic training and General Medical Council Specialist Registers. Results Out of the top 20 candidates in the exam, 29.5% went into specialist training in ophthalmology. Some appeared in the top 20 more than once, with 56% of them going into ophthalmic training, but they had a similar median time to enter training as those who appeared in the top 20 once. There was no significant evidence to suggest that the overall median ranking scores between the UK medical schools differed (P=0.23; Kruskal–Wallis test). However, there was a marked difference in frequency of top 20 candidates from each medical school, which could not be explained by the size of the medical school alone. Conclusion It is difficult to conclude from these findings the importance that the Duke–Elder examination has in the selection of trainees into ophthalmology. The role of cognitive factors in selection into postgraduate medical/surgical training is discussed, along with the potential academic criteria, which may influence interview scores. PMID:21587276
Kharlap, S I
Historic aspects of ultrasound diagnostics in ophthalmology are described. The technological development of ultrasound diagnostic systems and the clinical application of different ultrasound modes in examining the eye and its choroids are traced back. The efficiency of Doppler mapping in the mode of three-dimension reconstruction at examining the orbital vascular system is evaluated. An experience obtained at the Research Institute for Eye Disease of the Russian Academy of Medical Sciences and outlooks for the diagnostic usage of computer ultrasound in clinical ophthalmology and angiologia are presented.
Leffler, Christopher T; Schwartz, Stephen G; Wainsztein, Ricardo D; Pflugrath, Adam; Peterson, Eric
New World plants, such as tobacco, tomato, and chili, were held to have beneficial effects on the eyes. Indigenous healers rubbed or scraped the eyes or eyelids to treat inflammation, corneal opacities, and even eye irritation from smoke. European settlers used harsh treatments, such as bleeding and blistering, when the eyes were inflamed or had loss of vision with a normal appearance (gutta serena). In New Spain, surgery for corneal opacity was performed in 1601 and cataract couching in 1611. North American physicians knew of contralateral loss of vision after trauma or surgery (sympathetic ophthalmia), which they called “sympathy.” To date, the earliest identified cataract couching by a surgeon trained in the New World was performed in 1769 by John Bartlett of Rhode Island. The American Revolution negatively affected ophthalmology, as loyalist surgeons were expelled and others were consumed with wartime activities. After the war, cataract extraction was imported to America in earnest and academic development resumed. Charles F Bartlett, the son of John, performed cataract extraction but was also a “rapacious privateer.” In 1801, a doctor in the frontier territory of Kentucky observed anticholinergic poisoning by Datura stramonium (Jimsonweed) and suggested that this agent be applied topically to dilate the pupil before cataract extraction. John Warren at Harvard preferred couching in the 1790s, but, after his son returned from European training, recommended treating angle closure glaucoma by lens extraction. Other eye procedures described or advertised in America before the 19th century included enucleation, resection of conjunctival lesions or periocular tumors, treatment of lacrimal fistula, and fitting of prosthetic eyes. PMID:28804247
Christopher T Leffler
Full Text Available New World plants, such as tobacco, tomato, and chili, were held to have beneficial effects on the eyes. Indigenous healers rubbed or scraped the eyes or eyelids to treat inflammation, corneal opacities, and even eye irritation from smoke. European settlers used harsh treatments, such as bleeding and blistering, when the eyes were inflamed or had loss of vision with a normal appearance (gutta serena. In New Spain, surgery for corneal opacity was performed in 1601 and cataract couching in 1611. North American physicians knew of contralateral loss of vision after trauma or surgery (sympathetic ophthalmia, which they called “sympathy.” To date, the earliest identified cataract couching by a surgeon trained in the New World was performed in 1769 by John Bartlett of Rhode Island. The American Revolution negatively affected ophthalmology, as loyalist surgeons were expelled and others were consumed with wartime activities. After the war, cataract extraction was imported to America in earnest and academic development resumed. Charles F Bartlett, the son of John, performed cataract extraction but was also a “rapacious privateer.” In 1801, a doctor in the frontier territory of Kentucky observed anticholinergic poisoning by Datura stramonium (Jimsonweed and suggested that this agent be applied topically to dilate the pupil before cataract extraction. John Warren at Harvard preferred couching in the 1790s, but, after his son returned from European training, recommended treating angle closure glaucoma by lens extraction. Other eye procedures described or advertised in America before the 19th century included enucleation, resection of conjunctival lesions or periocular tumors, treatment of lacrimal fistula, and fitting of prosthetic eyes.
Sunaric-Mégevand, Gordana; Aclimandos, Wagih
The comprehensive European Board of Ophthalmology Diploma (EBOD) examination is one of 38 European medical specialty examinations. This review aims at disclosing the specific procedures and content of the EBOD examination. It is a descriptive study summarizing the present organization of the EBOD examination. It is the 3rd largest European postgraduate medical assessment after anaesthesiology and cardiology. The master language is English for the Part 1 written test (knowledge test with 52 modified type X multiple-choice questions) (in the past the written test was also available in French and German). Ophthalmology training of minimum 4 years in a full or associated European Union of Medical Specialists (UEMS) member state is a prerequisite. Problem-solving skills are tested in the Part 2 oral assessment, which is a viva of 4 subjects conducted in English with support for native language whenever feasible. The comprehensive EBOD examination is one of the leading examinations organized by UEMS European Boards or Specialist Sections from the point of number of examinees, item banking, and item contents. PMID:27464640
Full Text Available Background/Aim. Retinopathy of prematurity (ROP is a multifactorial disease in premature infants. The aim of this study was to determine the incidence of ROP in children treated at the Center of Neonatology, Pediatric Clinic, Clinical Center in Kragujevac, Serbia. Methods. The study covered all children with birth weight below 2,000 g and/or gestational age below the 37th week, who from June 2006 to December 2009 underwent ophthalmological examination for ROP. The results of fundoscopy were classified in accordance with the International Classification of ROP. The treatment of infants and those with ROP was conducted in accordance with the early treatment of ROP study recommendations. We analyzed gestational age, birth weight and postconceptional age in two groups: healthy infants and those with severe form of ROP. Statistical analysis was performed using the SPSS 16. Results. A total of 478 children met the criteria of screening for ROP. Severe stage of ROP, which required laser treatment, had 102 (21.3% children. Out of the infants with severe ROP 14 (13.7% of the infants with APD had aggressive posterior disease, while two (0.4% remained blind. The differences in the mean values of gestational age between the healthy and the children with severe form of the disease were statistically significant (p < 0.0005. The mean value of gestational age for the healthy children was 33.33 ± 2.28 weeks and for the seek infants 30.66 ± 2.79 weeks. The mean value of the weight in healthy children was 1.981 ± 407 g, and in sick children 1.535 ± 434 g which was statistically significant (p < 0.0005. Multivariate binary logistic regression showed that the occurrence of the disease depends on body weight and gestational age. Conclusion. The incidence of severe forms of ROP was 21.3%. Aggressive form of ROP was present in 13.7% of the children. The cut-off value for body weight was 1.740 g, and for gestational age 32.5 weeks.
Kuba, Miroslav; Liláková, Dana; Hejcmanová, Dagmar; Kremlácek, Jan; Langrová, Jana; Kubová, Zuzana
Five children with a history of preterm birth (mean gestational age of 27 weeks; birth weight 870-1,380 g) and perinatal post-hemorrhagic hydrocephalus were examined ophthalmologically at ages ranging from 4-11 years. An extended visual evoked potentials (VEPs) examination was simultaneously performed, using pattern-reversal, motion-onset, and cognitive visual stimuli. Although 3 of the 10 eyes displayed about normal visual acuity (> or =0.9), all of the examined eyes were abnormal for at least one variant of the tested VEPs. Pathological changes in VEPs (missing responses, shape abnormalities due to delayed VEPs maturation, prolonged peak latencies, and reduced amplitudes) were roughly proportional to both gestational age and reduction in visual acuity. A more severe pathology was found in the motion-onset VEPs (in all five subjects - nine eyes) when compared to the pattern-reversal VEPs (in four subjects - eight eyes). These observations suggest that the magnocellular system/dorsal stream of the visual pathway (which is particularly activated in response to motion stimuli) may be more frequently affected in preterm children than the parvocellular system/ventral stream (tested mostly by the standard pattern-reversal VEPs). This pilot study may encourage further testing of the combined pattern and motion-related VEPs examinations in preterm children as a way of detecting hidden cortical/cerebral visual impairment (CVI).
Full Text Available Michael M Vigoda, Azeema Latiff, Timothy G Murray, Jacqueline L Tutiven, Audina M Berrocal, Steven GayerBascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USAPurpose: To document that with proper patient and procedure selection, children undergoing general inhalational anesthesia for ophthalmologic exams (with or without photos, ultrasound, laser treatment, peri-ocular injection of chemotherapy, suture removal, and/or replacement of ocular prosthesis can be safely anesthetized without the use of an intravenous (IV line. Children are rarely anesthetized without IV access placement. We performed a retrospective study to determine our incidence of IV access placement during examinations under anesthesia (EUA and the incidence of adverse events that required intraoperative IV access placement.Methods: Data collected from our operating room (OR information system includes but is not limited to diagnosis, anesthesiologist, surgeon, and location of IV catheter (if applicable, patient’s date of birth, actual procedure, and anesthesia/procedure times. We reviewed the OR and anesthetic records of children (>1 month and <10 years who underwent EUAs between January 1, 2003 and May 31, 2009. We determined the percentage of children who were anesthetized without IV access placement, as well as the incidence of any adverse events that required IV access placement, intraoperatively.Results: We analyzed data from 3196 procedures performed during a 77-month period. Patients’ ages ranged from 1 month to 9 years. Overall, 92% of procedures were performed without IV access placement. Procedure duration ranged from 1–39 minutes. Reasons for IV access placement included parental preference for antinausea medication and/or attending preference for IV access placement. No child who underwent anesthesia without an IV line had an intraoperative adverse event requiring insertion of an IV line.Conclusion: Our data suggest that for
Fábio Barroso; Ana Lachado; Luísa Carreira; Gilberta Santos; José Pombeiro; Vasco Miranda
Introduction: Limbal dermoids are benign congenital tumours that contain choristomatous elements. These lesions are present at birth but may not be easily identified until later in life. Case report: We report a case of a one-day-old newborn, female, with no relevant gestational or neonatal history, referred to our pediatric ophthalmologic unit because of a whitish round mass in the inferotemporal limbus of the left eye. Clinical examination confirmed the diagnosis of limbal dermoid cyst, ...
Full Text Available Background. Parkinson’s disease (PD progressively affects dopaminergic neurotransmission and may affect retinal dopaminergic functions and structures. Objective. This 2-year randomized, open-label, parallel-group, flexible-dose study, NCT00144300, evaluated ophthalmologic safety profiles of immediate-release (IR pramipexole and ropinirole in patients with early idiopathic PD with ≤6 months’ prior dopamine agonist exposure and without preexisting major eye disorders. Methods. Patients received labeled IR regimens of pramipexole (n=121 or ropinirole (n=125 for 2 years. Comprehensive ophthalmologic assessments (COA included corrected acuity, Roth 28-color test, slit-lamp biomicroscopy, intraocular pressure, computerized visual field test, fundus photography, and electroretinography. Results. At baseline, we observed retinal pigmentary epithelium (RPE hypopigmentation not previously reported in PD patients. The estimated relative risk of 2-year COA worsening with pramipexole versus ropinirole was 1.07 (95% CI: 0.71–1.60. Mean changes from baseline in Unified Parkinson’s Disease Rating System parts II+III total scores (pramipexole: 1 year, −4.1±8.9, and 2 years, −0.7±10.1, and ropinirole: 1 year, −3.7±8.2, and 2 years, −1.7±10.5 and Hoehn–Yahr stage distribution showed therapeutic effects on PD symptoms. Safety profiles were consistent with labeling. Conclusions. The risk of retinal deterioration did not differ in early idiopathic PD patients receiving pramipexole versus ropinirole. RPE hypopigmentation at baseline was not previously reported in this population. This trial is registered with NCT00144300.
Somayeh Hejazi, MD
Conclusion: According to this study, the presence of blisters at the time of exposure to SM is the most important predictor of developing dermatologic complications decades later in patients with severe ophthalmologic complications from sulfur mustard exposure.
Kurt, Ali; Öktem, Çağlar; Karabıçak Acer, Ayşe; Kocamış, Özkan; Taşdemir, Sedat
To determine whether binocular B class driving licence (BBCDL) holders over 50 years old are in compliance with the BBCDL criteria for visual acuity, to determine the age-based prevalence of ophthalmological disorders reducing visual acuity in this group, and to investigate whether periodic ophthalmological examinations are needed in licence holders over 50 years of age. This prospective study enrolled 451 adults over 50 years old having a BBCDL. The study subjects were categorized into 3 age groups as group 1 (51-60 years), group 2 (61-70 years), and group 3 (over 71 years). The mean age of the subjects was 60.02±7.27 years; 338 (74.9%) were male and 113 (25.1%) were female. The BBCDL criteria were met by 353 (78.3%) subjects whereas 98 (21.7%) subjects did not meet them. Eighty-four (85.7%) of 98 patients not meeting BBCDL criteria still drove. The mean age of the subjects meeting BBCDL criteria (58.82±6.77 years) was significantly lower than the subjects not meeting them (64.34±7.40 years) (p<0.001). The most common pathologies in the individuals still driving despite not meeting BBCDL criteria were senile cataract (38.5%) and diabetic retinopathy (23.1%) in group 1, senile cataract (55.3%) and diabetic retinopathy (14.9%) in group 2, and senile cataract (63.6%) and senile macular degeneration+senile cataract (18.2%) in group 3. More than a fifth of individuals over 50 years old did not meet the BBCDL criteria, due predominantly to senile cataract, and the majority of these individuals continue to drive. Therefore, we believe that individuals over 50 years old who have a BBCDL should undergo periodic ophthalmological examinations.
Yoon, Kyung Chul; Choi, Won; Lee, Hyo Seok; Kim, Sang-Duck; Kim, Seung-Hyun; Kim, Chan Yun; Park, Ki Ho; Park, Young Jeung; Baek, Seung-Hee; Song, Su Jeong; Shin, Jae Pil; Yang, Suk-Woo; Yu, Seung-Young; Lee, Jong Soo; Lim, Key Hwan; Oh, Kyung Won; Kang, Se Woong
The Korea National Health and Nutrition Examination Survey (KNHANES) is a national program designed to assess the health and nutritional status of the noninstitutionalized population of South Korea. The KNHANES was initiated in 1998 and has been conducted annually since 2007. Starting in the latter half of 2008, ophthalmologic examinations were included in the survey in order to investigate the prevalence and risk factors of common eye diseases such as visual impairment, refractive errors, strabismus, blepharoptosis, cataract, pterygium, diabetic retinopathy, age-related macular degeneration, glaucoma, dry eye disease, and color vision deficiency. The measurements included in the ophthalmic questionnaire and examination methods were modified in the KNHANES IV, V, and VI. In this article, we provide detailed information about the methodology of the ophthalmic examinations in KNHANES in order to aid in further investigations related to major eye diseases in South Korea.
Full Text Available This article discusses how to clinically assess the visual pathway, examine the optic disc, check the pupil light reflexes and assess the extraocular movements in patients presenting with visual loss and/or diplopia.
Nov 4, 2016 ... Abstracts. 33. Nigerian Journal of Ophthalmology / Supplement 1 - 2014 - Volume 22. S33. Pattern of Ocular Injuries in Patients Presenting at FMC, Abeokuta. Sijuwola O.O., Awodein O. G., Eni-Olorunda A. D., Benjamin N. B.,. Rwang P. H.. Affiliation: Ophthalmology Department, Federal Medical Centre Idi-.
This article traces early career of Kong Pyung Woo, a public figure famous for being the first doctor of medicine in ophthalmology with Korean ethnicity in 1936, for founding and running the oldest and still the most successful private eye clinic in Korea since 1937, and also for his engagement in development of Korean mechanical typewriter since 1949. His case is an illustrative example of how a Korean under the Japanese colonial rule (1910-1945) could build up a career to become a medical doctor, taking full advantage of the chances available. Kong, born in 1907 in a rural province in northwestern Korea, acquired a doctor's license in 1926 by passing the qualifying examination of the Government General in Korea. The qualification test was in itself an outcome of colonial education system, in which the supply of medical doctors by only a few tertiary schools could not meet the demands. After working for a state hospital for one year, Kong volunteered to be a visiting student at Keijo Medical College, to fulfill his dream of "becoming a prominent bacteriologist like Noguchi Hideyo." He was soon officially appointed as a tutor at Department of Ophthalmology, as he had been endorsed by professor Satake Shyuichi for his diligence and earnestness. Satake also encouraged Kong to pursue a doctoral degree and recommended him to Tokumitsu Yoshitomi, a professor in the Department of Pathology at Keijo Imperial University, so that Kong could experience cutting-edge research at the imperial university. Kong reported on his experiments on the pathology of chorioretinitis centralis by 1935. He submitted the reports to Nagoya Imperial University, Japan, as a doctoral thesis, and eventually obtained the degree in 1936, which was the first Korean doctor of medicine in ophthalmology. The doctorate made Kong a public figure and he opened his own private clinic in 1937. The Kong Eye Clinic was the first private eye clinic owned and run by Korean, and soon became popular in Seoul
Robb, Richard M.
The author points out the need for early screening for ophthalmologic disorders and reviews symptoms of various eye disorders. Among the types of eye pathology considered are retinoblastoma, retrolental fibroplasia, congenital glaucoma, congenital cataracts, congenital strabismus, chlamydia oculogenitalis, orbital cellulitis, and eye injuries.…
Stefánsson, Einar; Zetterström, Charlotta; Ehlers, Niels
Ophthalmology, eye research, cornea, catarcat, paediatric ophthalmology, glaucoma, diabetic eye disease, age-related macular degeneration, ophthalmic oncology......Ophthalmology, eye research, cornea, catarcat, paediatric ophthalmology, glaucoma, diabetic eye disease, age-related macular degeneration, ophthalmic oncology...
Full Text Available Science, medicine and ophthalmology have all evolved and progressed through varied but powerful influences over the centuries. While the tremendous technological advances in ophthalmology in the past 20 years are readily appreciated, many clinicians fail to grasp the impact of the several clinical trials that have contributed to better patient care. This article briefly traces the history of science, medicine and ophthalmology, and explains how scientific thinking could be applied to the clinical and academic aspects of ophthalmology.
Full Text Available Cerebral palsy (CP is a chronic disease which is seen in early childhood, i.e. in the first two years of life. It is a non-progressive disorder resulting from a defect or lesion in the immature brain and thus leading to posture and movement disorders. The reason for facing high rates of ophthalmologic problems in CP cases is that visual functions are covered in a large area in the brain. While vision defect in the normal population ranges from 4 to 5%, this rate in children with CP is nearly ten times more . Given that patients with CP are not followed up, the ophthalmologic examination is performed in advanced stages and that there are difficulties in spectacle use, amblyopia is detected more often in those patients than in healthy people. The treatment of CP patients needs multi-disciplinary cooperation. So, CP patients must be referred to ophthalmologists for a detailed examination in the early stages. Furthermore, other accompanying disorders (audiologic, orthopedic and psychiatric should be evaluated and rehabilitation programmes should be carefully applied in early stages to help CP patients achieve healthy lifestyle. (Turk J Oph thal mol 2012; 42: 219-26
Nigerian Journal of Ophthalmology / Supplement 1 - 2015 - Volume 23. S8. Confrontation Visual Field Testing in Routine Ophthalmic Practice: What is The Relevance? Abiola A. Salimonu1, Vivian B. Osaguona1,2. 1Department of Ophthalmology, University of Benin Teaching Hospital,. Benin City, Edo State, Nigeria, ...
Full Text Available Ophthalmology is an expensive field and imaging is an indispensable modality in ophthalmology; and in developing countries including India, it is not possible for every ophthalmologist to afford slit-lamp photography unit. We here present our experience of slit-lamp photography using digital camera. Good quality pictures of anterior and posterior segment disorders were captured using readily available devices. It can be a used as a good teaching tool for residents learning ophthalmology and can also be a method to document lesions which at many times is necessary for medicolegal purposes. It's a technique which is simple, inexpensive, and has a short learning curve.
The need to counsel patients with genetic ophthalmological problems is stressed in the article. Assessment of autosomal dominance or autosomal recessitivity in an individual is explained and sex-linked heredity is traced. Practical examples of genetic abnormalities, such as pigmentary retinopathy and chorodineremia, are discussed. (PHR)
Pop-Jordanova, Nada; Ristova, Jovanka; Loleska, Sofija
Vision is the most important sensorial part of the human information system. Visual loss leads to reduced ability to perform routine activities of daily living and can be a risk for stable mental health. The aim of this cross-sectional study is to assess the incidence of depression in patients treated in an ophthalmological outpatient clinic. To our knowledge this is the first study of its kind in our country. The number of evaluated patients was a hundred; mean age 41.6 ± 15.9 years, with different educational levels and common ophthalmological disorders. For the assessment of the level of depression the Beck Depression Inventory was used. Patients were divided into two groups: serious ophthalmological diagnoses where we expected psychological problems (N = 65) and the simplest ones (N = 35) as a control. Obtained results show that the levels of depression correlate with the diagnoses. Patients in the first group (serious ophthalmological diagnoses) showed moderate depression in 12% and severe in 13% of patients. It was shown that the most depressed were the patients suffering from age-related macular degeneration and proliferative diabetic retinopathy, as well as glaucoma and cataract. The second group showed BDI scores of normal values. The level of depression is positively correlated with age and the level of education (p eyes diseases. Some measures for mitigation of psychological problems are proposed.
Bowker, Julie C.; Thomas, Katelyn K.; Spencer, Sarah V.; Park, Lora E.
The present study of 150 adolescents ("M" age = 13.05 years) examined the associations between appearance-based rejection sensitivity (Appearance-RS) and psychological adjustment during early adolescence, and evaluated three types of other-gender peer experiences (other-gender friendship, peer acceptance, and romantic relationships) as…
Kalina, Robert E.; And Others
The results of two Association of University Professors of Ophthalmology (AUPO) surveys of ophthalmology teaching are reported. The results indicate that currently assigned time for teaching ophthalmology is limited and gradually declining. A main concern is that students learn proper diagnosis to avoid inappropriate referral. (Author/MLW)
Ali Ihsan Incesu
Full Text Available Simulation can be defined as malingering, or sometimes functional visual loss (FVL. It manifests as either simulating an ophthalmic disease (positive simulation, or denial of ophthalmic disease (negative simulation. Conscious behavior and compensation or indemnity claims are prominent features of simulation. Since some authors suggest that this is a manifestation of underlying psychopathology, even conversion is included in this context. In today’s world, every ophthalmologist can face with simulation of ophthalmic disease or disorder. In case of simulation suspect, the physician’s responsibility is to prove the simulation considering the disease/disorder first, and simulation as an exclusion. In simulation examinations, the physician should be firm and smart to select appropriate test(s to convince not only the subject, but also the judge in case of indemnity or compensation trials. Almost all ophthalmic sensory and motor functions including visual acuity, visual field, color vision and night vision can be the subject of simulation. Examiner must be skillful in selecting the most appropriate test. Apart from those in the literature, we included all kinds of simulation in ophthalmology. In addition, simulation examination techniques, such as, use of optical coherence tomography, frequency doubling perimetry (FDP, and modified polarization tests were also included. In this review, we made a thorough literature search, and added our experiences to give the readers up-to-date information on malingering or simulation in ophthalmology.
Kim, Bo Hee; Yu, Young Suk
Purpose To describe the characteristics and frequency of ophthalmologic findings in patients with Lennox-Gastaut syndrome (LGS). Methods The medical records of patients diagnosed with LGS at Seoul National University Children's Hospital from January 2004 to August 2014 were retrospectively reviewed. The records of 34 patients (mean age ± standard deviation, 2.66 ± 3.51 years; male, 58.8%) were reviewed. The primary measure was the incidence of ophthalmologic manifestations. Results Of the 34 patients, 88.2% had at least one ocular abnormality. Refractive error (52.9%) was the most frequently observed ophthalmologic manifestation in patients with LGS, followed by strabismus (32.4%), cortical visual impairment (23.5%), and retinopathy of prematurity (8.8%). Among these cases, seven patients had exotropia and three had esotropia. Conclusions LGS is a childhood-onset epileptic encephalopathy with variable ophthalmologic manifestations, the most frequent being refractive errors. Patients with suspected LGS should be examined regularly because ophthalmological features can change during their disease course. PMID:28471101
Otacílio de Oliveira Maia Júnior
asymptomatic diabetic patients. All were eligible to retinal panphotocoagulation in at least one eye. Duration and type of the disease as well as time of the first ophthalmic examination were established. RESULTS: Of the 44 patients, 6 (13.7% had diabetes type 1 and 38 (86.3% had diabetes type 2. Proliferative diabetic retinopathy was present in 24 (54.5% and severe or very severe non proliferative retinopathy was present in 20 (45.5%. Best visual acuity ranged from 0.5 to 1.0 (mean 0.83 ± 0.17 according to the Snellen chart. The time interval between diagnosis of diabetes and the first ophthalmic examination ranged from 7 to 19.5 years (13.2 ± 5.12 for diabetes type 1 and from 3 months to 18 years (5.2± 4.81 for diabetes type 2. CONCLUSION: Advanced diabetic retinopathy may be detected at different times of the ophthalmic examination in both types of diabetes. Although the mean interval between the diagnosis and the first examination is 13 years for diabetes type 1 and 5 years for diabetes type 2, this severe kind of retinopathy occurred as early as three months after diagnosis of diabetes. This points to the need for an earlier ophthalmic examination in the case of this disease.
Loukas, Alexandra; Ripperger-Suhler, Ken G; Horton, Karissa D
This study examined (a) the associations between school connectedness and early adolescent adjustment problems over a 1 year period and (b) the equivalence of these associations across gender. Five hundred middle school students (53.4% female), initially in the 6th and 7th grades, participated in the two-wave study. Results from two-group cross-lagged panel analyses were consistent across boys' and girls' data. After controlling for baseline levels of adjustment problems, school connectedness predicted lower levels of early adolescent conduct problems 1 year later. Regarding the opposite direction of associations, and even after baseline levels of school connectedness were taken into account, conduct problems predicted lower levels of subsequent school connectedness. There were no cross-lagged associations between depressive symptoms and school connectedness, although elevated levels of baseline depressive symptoms predicted higher levels of subsequent conduct problems. Findings elaborate previous research by demonstrating that early adolescents actively shape the middle school environment.
Full Text Available Alzheimer's disease is a progressive neurodegenerative disorder causing irreversible deterioration in memory and loss of self-care ability, which is seriously affecting the quality of life. There is no cure for Alzheimer's disease. Medication only can control the progression of the disease. Early diagnosis and control of disease progress is of great significance in improving the quality of life of the patients and reducing the burden of family and society. Ophthalmic examination is seen as a window which can “see” brain directly, and some changes in the eye can reflect the changes of the brain most directly. This paper reviews the ophthalmic examination of Alzheimer's disease, including optical coherence tomography(OCT, visual field, contrast sensitivity and eye movements, et al. We hope to provide a new idea for the early diagnosis of Alzheimer's disease.
Aspectos socioeconômicos que influenciam no comparecimento ao exame oftalmológico de escolares com alterações visuais Socioeconomic aspects influencing the attendance at ophthalmologic examination of schoolchildren with visual impairment
Alfredo Borghetto Abud
Full Text Available OBJETIVO: Identificar aspectos socioeconômicos que influenciam no comparecimento de escolares com alterações visuais ao exame oftalmológico realizado durante campanha comunitária. MÉTODOS: Foram encaminhados para consulta 237 alunos. O questionário por entrevista (levantamento investigativo foi aplicado aos pais ou responsáveis que acompanharam os escolares durante a consulta oftalmológica da Campanha Nacional de Reabilitação Visual "Olho no Olho" 2002, na cidade de Lins. A escolaridade dos pais ou responsáveis, a renda familiar, a posse de condução própria, a distância entre as moradias e o local do exame e a posse de plano de saúde privado foram pesquisadas. O mesmo questionário foi posteriormente aplicado, por meio de visita domiciliar, aos pais ou responsáveis pelos escolares faltosos. RESULTADOS: Compareceram ao exame oftalmológico e responderam ao questionário 163 alunos (68,8%. Faltaram à consulta 74 alunos (31,2%, dos quais 72 responderam ao questionário. A escolaridade, a renda familiar, a posse de condução própria e a distância entre a casa do escolar e o local do exame não mostraram diferença estatisticamente significante entre os alunos que compareceram ao exame e os faltosos. Houve diferença estatisticamente significante (p = 0,017 entre os escolares com convênio médico privado que compareceram (27,6% e os que não compareceram (44,4% à consulta oftalmológica. CONCLUSÃO: O fato de o escolar estar protegido por convênio médico privado esteve associado ao não comparecimento para o exame oftalmológico.PURPOSE: To identify socioeconomic aspects influencing the attendance of schoolchildren, who showed visual impairment, at ophthalmologic examination. METHODS: 237 schoolchildren were referred to examinations. A survey questionnaire was applied to the parents or those responsible who accompanied the schoolchildren during the ophthalmologic appointment, of the National Campaign for Visual
V. D. Zavadovskaya
Full Text Available A peculiarity of the congenital syphilis of recent years is an increase of the number of cases of latent forms of the disease, marked with osteopathy. With the help of an examination of 50 children with early congenital syphilis, the following ultrasonic signs of a musculoskeletal system lesion were revealed: osteochondritis 90%, osteosclerosis 80%, and periostitis 30%.The comparison of the nature of a musculoskeletal system lesion with serological data of the specific process activity showed that complex manifestations of lesions with periostitis being a component were of the greatest clinical significance.
Beathard, Gerald A
Evaluation of a newly created fistula 4-6 weeks after surgery should be considered mandatory. If the fistula is going to become adequate for dialysis, it will be apparent at this time. This evaluation can be accomplished by physical examination. However, it must be performed by someone who is knowledgeable. Using a systematic approach facilitates the evaluation and ensures that a problem is not overlooked. Once it is determined that the fistula is dysfunctional, the case should be immediately referred for management to an interventionalist who is experienced in dealing with early fistula failure. The majority of these cases can be salvaged.
Ophthalmologic survey of atomic bomb survivors in Japan, 1949. Atomic bomb radiation cataract case report with histopathologic study. Medical examination of Hiroshima patients with radiation cataracts
Cogan, D.G.; Martin, S.F.; Kimura, S.J.; Ikui, Hiroshi; Fillmore, P.G.
This document contains 3 reports dealing with the delayed effects of radiation on the eyes of survivors of the atomic explosions in Hiroshima and Nagasaki. In the first study, 1000 persons who were listed as having been in the open and within two kilometers of the hypocenter at the time of the explosion were selected at random from the census files of the Atomic Bomb Casualty Commission for study. In addition, 231 others, comprising the total available number of surviving persons listed at present in the census files as having been within one kilometer of the hypocenter, were examined, as were several hundred others who were contacted through newspaper publicity, referrals from local ophthalmologists, or through hearsay. The survey resulted in bringing in persons having, or having had, a variety of ocular conditions. Those connected with the atomic bomb included the following diagnoses; multiple injuries of eyes and eyelids; keratoconjunctivitis from ultraviolet and ionizing radiations; thermal burn of the cornea and of the retina; retinitis proliferans; and radiation cataracts. The cataracts were the only delayed manifestations of ocular injury from the atomic bomb. The second paper is a case report of a histopathologic study of atomic bomb radiation cataract. The third paper presents the results of medical examinations of survivors having radiation induced cataracts. 32 references, 8 figures. (DMC)
Hanneken, Anne; Neikirk, Thomas; Johnson, Jennifer; Kono, Masahiro
To test the hypothesis that delayed dark adaptation in patients with macular degeneration is due to an excess of free unliganded opsin (apo-opsin) and a deficiency of the visual chromophore, 11 -cis retinal, in rod outer segments. A total of 50 human autopsy eyes were harvested from donors with and without macular degeneration within 2-24 hrs. postmortem. Protocols were developed which permitted dark adaptation of normal human eyes after death and enucleation. Biochemical methods of purifying rod outer segments were optimized and the concentration of rhodopsin and apo-opsin was measured with UV-visible scanning spectroscopy. The presence of apo-opsin was calculated by measuring the difference in the rhodopsin absorption spectra before and after the addition of 11 -cis retinal. A total of 20 normal eyes and 16 eyes from donors with early, intermediate and advanced stages of macular degeneration were included in the final analysis. Dark adaptation was achieved by harvesting whole globes in low light, transferring into dark (light-proof) canisters and dissecting the globes using infrared light and image converters for visualization. Apo-opsin was readily detected in positive controls after the addition of 11 -cis retinal. Normal autopsy eyes showed no evidence of apo-opsin. Eyes with macular degeneration also showed no evidence of apo-opsin, regardless of the severity of disease. Methods have been developed to study dark adaptation in human autopsy eyes. Eyes with age-related macular degeneration do not show a deficiency of 11 -cis retinal or an excess of apo-opsin within rod outer segments.
Vainer, Igor; Mimouni, Francis; Blumenthal, Eytan Z; Mimouni, Michael
To test whether there is an association between the growth in the number of ophthalmic journals in the past years and their mean and maximum impact factor (IF) as a common sign of scientific proliferation. Using data from the 2013 Journal Citation Report database a study of the major clinical medical fields was conducted to assess the correlation between the number of journals and maximum IF in a given field in the year 2013. In the field of ophthalmology, we examined the correlation between year, number of journals, mean IF and maximum IF in the field of ophthalmology throughout the years 2000-2013. In the major medical fields, a positive correlation was found between the number of journals and the maximum IF (quadratic R2 = 0.71, Pjournals and mean IF (R2 = 0.84, Pjournals and maximum IF (R2 = 0.71, Pjournals in the field of ophthalmology. In the future, the formation of additional ophthalmology journals is likely to further increase the IFs of existing journals.
Subspecialties Cataract/Anterior Segment Comprehensive Ophthalmology Cornea/External Disease Glaucoma Neuro-Ophthalmology/Orbit Pediatric Ophthalmology/Strabismus Ocular Pathology/Oncology Oculoplastics/Orbit Refractive Management/Intervention Retina/Vitreous Uveitis ...
Full Text Available The study aimed to gauge ophthalmology resident doctors′ perception of their teaching programs and various methods used in it and to formulate a well structured program for teaching ophthalmology. Closed ended and open-ended questionnaires were used for survey of ophthalmology residents in West Maharashtra, India. Sixty-seven out of 69 residents of seven residency programs completed the questionnaire. On a scale of 0 (most unsatisfactory to 4 (best, lectures with power point presentation had a median score of 4, didactic lectures 2, seminar 3, case presentation 4, wet lab 3 and journal club 3. There was a discrepancy in the actual number of surgeries performed by the resident doctors and their perception of the number needed to master those surgeries. Phacoemulsification and non-cataract surgery training was neglected in most programs. The residents wanted to be evaluated regularly and taught basic ophthalmic examination, use of equipments and procedures in greater depth.
Weber, Konrad P; Straumann, Dominik
This review summarizes the most relevant articles from the field of neuro-ophthalmology published in the Journal of Neurology from January 2012 to July 2013. With the advent of video-oculography, several articles describe new applications for eye movement recordings as a diagnostic tool for a wide range of disorders. In myasthenia gravis, anti-Kv1.4 and anti-Lrp4 have been characterized as promising novel autoantibodies for the diagnosis of hitherto 'seronegative' myasthenia gravis. Several articles address new diagnostic and therapeutic approaches to neuromyelitis optica, which further sharpen its profile as a distinct entity. Additionally, 4-aminopyridine has become a standard therapeutic for patients with cerebellar downbeat nystagmus. Finally, revised diagnostic criteria have been proposed for chronic relapsing inflammatory optic neuropathy based on a careful literature review over the last decade.
Full Text Available Suturing is a time consuming task in ophthalmology and suture induced irritation and redness are frequent problems. Postoperative wound infection and corneal graft rejection are examples of possible suture related complications. To prevent these complications, ophthalmic surgeons are switching to sutureless surgery. A number of recent developments have established tissue adhesives like cyanoacrylate glue and fibrin glue as attractive alternatives to sutures. A possible and promising new application for tissue adhesives is to provide a platform for tissue engineering. Currently, tissue glue is being used for conjunctival closure following pterygium and strabismus surgery, forniceal reconstruction surgery, amniotic membrane transplantation, lamellar corneal grafting, closure of corneal perforations and descematoceles, management of conjunctival wound leaks after trabeculectomy, lid surgery, adnexal surgery and as a hemostat to minimise bleeding. The purpose of this review is to discuss the currently available information on fibrin glue.
American Association for Pediatric Ophthalmology and Strabismus Home About AAPOS Patient Info Resources Allied Health News & Events Meetings J AAPOS American Association for Pediatric Ophthalmology ...
A new generation of logarithmic reading charts has sparked interest in standardized reading performance analyses. Such reading charts have been developed according to the standards of the International Council of Ophthalmology. The print size progression in these calibrated charts is in accordance with the mathematical background of EN ISO 8596. These reading charts are: the Bailey-Lovie Word Reading Chart, the Colenbrander English Continuous Text Near Vision Cards, the Oculus Reading Probe II, the MNREAD Charts, the SKread Charts, and the RADNER Reading Charts. The test items used for these reading charts differ among the charts and are standardized to various extents. The Bailey-Lovie Charts, MNREAD Charts, SKread Charts, and RADNER Charts are also meant to measure reading speed and allow determination of further reading parameters such as reading acuity, reading speed based on reading acuity, critical print size, reading score, and logMAR/logRAD ratio. Such calibrated reading charts have already provided valuable insights into the reading performance of patients in many research studies. They are available in many languages and thus facilitate international communication about near visual performance. In the present review article, the backgrounds of these modern reading charts are presented, and their different levels of test-item standardization are discussed. Clinical research studies are mentioned, and a discussion about the immoderately high number of reading acuity notations is included. Using the logReading Acuity Determination ([logRAD] = reading acuity equivalent of logMAR) measure for research purposes would give reading acuity its own identity as a standardized reading parameter in ophthalmology.
Huang, Cindy Y.; Stormshak, Elizabeth A.
Early adolescence is marked by transitions for adolescents, and is also a time for identity exploration. Ethnic identity is an essential component of youths’ sense of self. In this study we examined the trajectories of ethnic identity for adolescents from ethnic minority backgrounds during a 4-year period. Six latent class trajectories were identified in the study: the majority of adolescents (41.8%) displayed growth in ethnic identity over 4 years, followed by 30.1% whose high levels of ethnic identity remained stable, then by those who experienced moderate decreases in ethnic identity (10.8 percent). Another class of adolescents (7.3%) showed significant declines in ethnic identity level, followed by 5.5% of adolescents with significant increases, and finally by 4.5% of adolescents with low stable levels of ethnic identity during this developmental period. The classes differed by ethnicity, and adolescents with increasing high levels of ethnic identity reported better parent–child relationships. Findings and implications are discussed. PMID:21787058
Huang, Cindy Y; Stormshak, Elizabeth A
Early adolescence is marked by transitions for adolescents, and is also a time for identity exploration. Ethnic identity is an essential component of youths' sense of self. In this study we examined the trajectories of ethnic identity for adolescents from ethnic minority backgrounds during a 4-year period. Six latent class trajectories were identified in the study: the majority of adolescents (41.8%) displayed growth in ethnic identity over 4 years, followed by 30.1% whose high levels of ethnic identity remained stable, then by those who experienced moderate decreases in ethnic identity (10.8%). Another class of adolescents (7.3%) showed significant declines in ethnic identity level, followed by 5.5% of adolescents with significant increases, and finally by 4.5% of adolescents with low stable levels of ethnic identity during this developmental period. The classes differed by ethnicity, and adolescents with increasing high levels of ethnic identity reported better parent-child relationships. Findings and implications are discussed.
Pekarik, Alexander S.; Linnik, Leonid A.; Kadan, Victor N.
Transscleral laser (YAG:Nd, (lambda) equals 1.06 micrometers ) for ophthalmology has been developed and assembled for pulse laser transscleral treatment of eyes structures by means of adaptive optical fibers tip. `Adaptivity' means that we have used some exactly defined levels of optical fiber tip contact pressure to eyes surface to replace intertissues liquid. Such kind of fiber tip permit us apply more laser irradiation power due to decreasing of laser beam absorption in the liquid of eyes tissue. The different laser power levels, pulse duration, exposure time have been considered in correspondence with many types of adaptive fiber optical tips to optimize both transscleral coagulation and cutting process. To exactly determine the dependencies of laser irradiation spatial distributions behind sclera via contact tips pressure levels we have used as a adequate enough model He-Ne laser and eyes tissue samples. Laser system consist of power supply, control unit, laser head with cooling system, adapter for different kind of optical fibers tips. All of the above has been mounted as one case.
Bleul, T; Schlunck, G; Reinhard, T; Lapp, T
Chemokines are chemotactically active cytokines, which coordinate the distribution of immune cells within the body and also regulate the migration of leukocytes in malignant and inflammatory processes. Chemokines are a heterogeneous group of short-chain proteins that are divided into different subgroups on the basis of their structure. In addition to the chemokines (ligands) various chemokine receptors also exist. The chemokine system is given its complexity by the high redundancy of ligand-receptor interactions: one single ligand can bind to different receptors and a single receptor can interact with different ligands. In terms of receptors, distinct immune cell types have characteristic receptor expression patterns, which can be used for the immunological characterization of leukocytes. Important basic research is currently leading to a better understanding of the chemokine system. The essential importance of the chemokine system in various diseases of the anterior and posterior eye segments is becoming increasingly apparent. The following synopsis explains the individual clinical aspects as well as the underlying scientific work in the context of "chemokines in ophthalmology".
Full Text Available Computers are already in widespread use in medical practice throughout the world and their utility and popularity is increasing day by day. While future generations of medical professionals will be computer literate with a corresponding increase in use of computers in medical practice, the current generation finds itself in a dilemma of how best to adapt to the fast-evolving world of information technology. In addition to practice management, information technology has already had a substantial impact on diagnostic medicine, especially in imaging techniques and maintenance of medical records. This information technology is now poised to make a big impact on the way we deliver medical care in India. Ophthalmology is no exception to this, but at present very few practices are either fully or partially computerized. This article provides a practical account of the uses and advantages of computers in ophthalmic practice, as well as a step-by-step approach to the optimal utilization of available computer technology.
Jelinkova, Helena; Pasta, Jiri; Sulc, Jan; Nemec, Michal; Miyagi, Mitsunobu; Shi, Yi-Wei; Matsuura, Yuji
A summary of using near (Nd) and middle (Er) infrared YAG laser systems in ophthalmology surgery is given in the paper. The report on twelve years of clinical experience with the ophthalmic Nd:YAG laser system (λ=1.06 μm) operating alternatively on Q-switched or mode-locked regimes is accomplished. From statistical data processing of more than 1000 interventions it follows that better results in a posterior capsule opacification cure are achieved with the use of short, near-infrared mode-locked 25 ps long pulses, while 4 ns long giant pulses of the same wavelength are useful for iridectomy creations. Middle infrared radiation generated by the Er:YAG laser system (λ-2.94 μm) was used for pre-clinical interaction experiments (in vitro). Differences in results of cornea, lens and sclera ablation by a free running (110 μs long) and Q-switched (250 ns long) mid-infrared pulses are presented. The radiation was delivered to the interaction place either by a system of reflected mirrors (used for Nd:YAG laser), or by a special sealed waveguide (in the case of Er:YAG system).
Manuscripts must be prepared in accordance with "Uniform requirements for Manuscripts submitted to Biomedical Journals" developed by the International Committee of Medical Journal Editors (October 2008). The uniform requirements and specific requirement of Nigerian Journal of Ophthalmology are summarized below.
Neuro-ophthalmological history may be very complex and difficult. This article provides 14 hints about how to construct history taking efficiently and how to avoid collecting unnecessary information. Georg Thieme Verlag KG Stuttgart · New York.
Full Text Available Building high performance teaching team of ophthalmology has a very important role for teachers' professional development and the improvement of the quality of ophthalmology personnel training. In this paper, the situation and existing problems of ophthalmology teaching team, the meaning of building ophthalmology teaching team, and the strategies for building team were considered.
Yi-Sheng Zhong; Xi Shen
Building high performance teaching team of ophthalmology has a very important role for teachers' professional development and the improvement of the quality of ophthalmology personnel training. In this paper, the situation and existing problems of ophthalmology teaching team, the meaning of building ophthalmology teaching team, and the strategies for building team were considered.
Fan, Jennifer C; Sherwin, Trevor; McGhee, Charles N J
Despite established international guidelines on preferred teaching components for ophthalmology in undergraduate curricula, with increasingly less specialty-based undergraduate teaching within curricula, teaching of core ophthalmology knowledge and skills may become marginalized. This survey aims to evaluate the current state of undergraduate ophthalmology teaching in Australasia and proximate Asian medical schools. A questionnaire was developed to determine the content and extent of ophthalmology teaching in the undergraduate medical curriculum. The questionnaire was sent to 25 medical schools throughout Australasia and Asia. Nineteen of the 25 questionnaires were returned (76% response rate). Ophthalmology teaching programmes ranged from 2 to 20 days: five (26%) medical schools having one ophthalmology attachment; six schools (32%) two attachments; and the remainder three or more. Only seven of the schools taught all 13 ophthalmology topics recommended in current curriculum guidelines. Ocular examination (100%), lens and cataract (95%) and ocular manifestations of systemic disease (95%) were the most commonly taught topics, with intraocular tumours only covered by 10 schools (53%). Students in 14 schools (74%) attended ophthalmology operating theatre, but only two schools (11%) offered attendance at optometry clinics. Ten schools (53%) required a pass in ophthalmology to complete the academic year. Ophthalmology may increasingly be a small, or even absent, component of undergraduate medical curricula. Despite established international ophthalmology curriculum guidelines, this survey highlights significant lack of uniformity in their implementation.
Kanjee, Raageen; Dookeran, Ravi I; Mathen, Mathen K; Stockl, Frank A; Leicht, Richard
The purpose of this study was to evaluate the diabetic retinopathy (DR) tele-ophthalmology screening program in Manitoba to determine prevalence and incidence of DR, as well as to estimate the program's cost-effectiveness. Retrospective chart review. A total of 4676 patients with type 2 diabetes examined 9334 times from 2007 to 2013. Focused ophthalmic histories were recorded and examinations were performed by trained nurses, including visual acuities, intraocular pressure, and mydriatic 7 standard field stereoscopic fundus photography. Images were evaluated by retinal specialists according to the Early Treatment of Diabetic Retinopathy Study criteria. DR prevalence and incidence were then calculated during the study period. Cost-effectiveness was estimated by comparing the cost of running the tele-ophthalmology program compared with the cost of screening the same volume of patients in-office. The average prevalence of any DR in each year was 25.1%. The cumulative incidence of DR across 6 years was 17.1% (95% CI, 15.4%-18.7%). The average savings per tele-ophthalmology examination was $1007. DR is highly prevalent among the studied population. Tele-ophthalmology provides a cost-effective means of monitoring patients as well as identifying new or treatable disease. Copyright © 2017. Published by Elsevier Inc.
Spitze, Arielle; Al-Zubidi, Nagham; Lam, Peter; Yalamanchili, Sushma; Lee, Andrew G
This essay was written to discuss the reasoning behind the personal decisions made by 2 current neuro-ophthalmology fellows to pursue neuro-ophthalmology as a career. It is meant to enlighten the reader about what role neuro-ophthalmologists play in clinical practice, what makes neuro-ophthalmology unique to all other sub-specialties, and how this contributes to making neuro-ophthalmology not only one of the most medically interesting, yet rewarding sub-specialties in ophthalmology. PMID:25449937
Spitze, Arielle; Al-Zubidi, Nagham; Lam, Peter; Yalamanchili, Sushma; Lee, Andrew G
This essay was written to discuss the reasoning behind the personal decisions made by 2 current neuro-ophthalmology fellows to pursue neuro-ophthalmology as a career. It is meant to enlighten the reader about what role neuro-ophthalmologists play in clinical practice, what makes neuro-ophthalmology unique to all other sub-specialties, and how this contributes to making neuro-ophthalmology not only one of the most medically interesting, yet rewarding sub-specialties in ophthalmology.
Ribeiro, Paulo A.
The clinical application of lasers in ophthalmology is schematized, showing for each anatomic eye structure, pathologies that may be treated through this procedure. In the cornea, the unusual laser practice for suture removals and the promising possibility of the excimer laser in refractive surgery are discussed. In the iris, the camerular angle, and the ciliary body, the laser application is essentially used to treat the glaucoma and other situations that are not so frequent. The capsulotomy with YAG LASER is used in the treatment of structures related with crystalline and, at least, the treatment of the retina and choroid pathology is expanded. A. A. explained the primordial interest and important of laser in the diabetic retinopathy treatment and some results in patients with more than 5 years of evolution are: 55 of the patients with proliferative diabetic retinopathy (RDP) treated for more than 5 years noticed their vision improved or stabilized; 5 years after treating patients with PDR, 49.3 had their vision stabilized or even improved, provided the diabetics had declared itself more than 20 years ago, versus 61.7 provided the diabetics had declared itself less than 20 years before; finally, 53.8 of the patients under 40-years-old when the diabetics was diagnosed, had their vision improved or at least stabilized 5 years after the beginning of the treatment. On the other side, when patients were over 40 years old when the diabetics was diagnosed percentage increased to 55.9. This study was established in the follow-up of 149 cases over 10 years.
Zvornicanin, Edita; Zvornicanin, Jasmin; Hadziefendic, Bahrudin
Smart phones are being increasingly used among health professionals. Ophthalmological applications are widely available and can turn smart phones into sophisticated medical devices. Smart phones can be useful instruments for the practice of evidence-based medicine, professional education, mobile clinical communication, patient education, disease self-management, remote patient monitoring or as powerful administrative tools. Several applications are available for different ophthalmological examinations that can assess visual acuity, color vision, astigmatism, pupil size, Amsler grid test and more. Smart phones can be useful ophthalmic devices for taking images of anterior and posterior eye segment. Professional literature and educational material for patients are easily available with use of smart phones. Smart phones can store great amount of informations and are useful for long term monitoring with caution for patient confidentiality. The use of smart phones especially as diagnostic tools is not standardized and results should be carefully considered. Innovative role of smartphone technology and its use in research, education and information sharing makes smart phones a future of ophthalmology and medicine.
Hilkert, Sarah M.; Cebulla, Colleen M.; Jain, Shelly Gupta; Pfeil, Sheryl A.; Benes, Susan C.; Robbins, Shira L.
As the ophthalmology accreditation system undergoes major changes, training programs must evaluate residents in the 6 core competencies, including appropriately communicating bad news. Although the literature is replete with recommendations for breaking bad news across various non-ophthalmology specialties, no formal training programs exist for ophthalmology. There are many valuable lessons to be learned from our non-ophthalmology colleagues regarding this important skill. We examine the historic basis for breaking bad news, explores current recommendations among other specialties, and then evaluate a pilot study to teach breaking bad news to ophthalmology residents. The results of this study are limited by a small number of residents at a single academic center. Future studies from multiple training programs should be conducted to further evaluate the need and efficacy of formal communication skills training in this area, as well as the generalizability of our pilot training program. If validated, this work could serve as a template for future ophthalmology resident training and evaluation in this core competency. PMID:27134009
Lee, Sandra; Huang, Hui; Zelen, Marvin
Special examinations exist for many chronic diseases, which can diagnose the disease while it is asymptomatic, with no signs or symptoms. The earlier detection of disease may lead to more cures or longer survival. This possibility has led to public health programs which recommend populations to have periodic screening examinations for detecting specific chronic diseases, for example, cancer, diabetes, cardiovascular disease and so on. Such examination schedules when embedded in a public health program are invariably costly and are ordinarily not chosen on the basis of possible trade-offs in costs and benefits for different screening schedules. The possible candidate number of examination schedules is so large that it is not feasible to carry out clinical trials to compare different schedules. Instead, this problem can be investigated by developing a theoretical model which can predict the eventual disease specific mortality for different examination schedules. We have developed such a model. It is a stochastic model which assumes that i) the natural history of the disease is progressive and ii) any benefit from earlier diagnosis is due to a change in the distribution of disease stages at diagnosis (stage shift). The model is general and can be applied to any chronic disease which satisfies our two basic assumptions. We discuss the basic ideas of schedule sensitivity and lifetime schedule sensitivity and its relation to the reduction in disease specific mortality. Our theory is illustrated by applications to breast cancer screening. The investigation of schedules compares not only examination schedules with equal intervals between examinations but also staggered schedules using the threshold method. (Examinations are carried out when an individual's risk status reaches a preassigned threshold value.).
Although orthopedics and ophthalmology seem to be two different medical specialties, numerous studies that have been conducted in the past 35 years have shown a tight connection between several ocular pathologies and an increased risk of hip fractures due to falling. This article aims to review the ocular pathologies that have been proven to be associated with an increased risk of falling, to integrate the results of several studies showing a direct relationship between ocular pathologies and an increased risk of falling and finally to suggest ways in which the incidence of traumatic orthopedic injuries can be reduced by applying ophthalmologic principles.
Transactions of the Ophthalmological Society of Nigeria: Proceedings of the annual OSN Conference, Jos, Nigeria, August 25–28, 2015. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · AJOL African Journals Online. HOW TO USE AJOL... for Researchers ...
Conclusion: Prenatal diagnosis of cervical teratoma is very crucial, allowing early detection of masses that obstruct the airway. Therefore, a multidisciplinary examination and follow-up are recommended for early prenatal diagnosis.
Bowker, Julie C.
This study examined young adolescents' experiences with best friendship dissolution. Participants were 77 sixth-grade students (M age = 11.63 years, SD = 0.36; 11.00-12.69 age range) who reported on past experiences with (1) "complete dissolutions" (when friendship ties are completely severed), and (2) "downgrade dissolutions"…
Hilado, Aimee V.; Kallemeyn, Leanne; Phillips, Lauren
The importance of parent involvement in children's development and learning is increasingly recognized in the research literature and in federal and state policies; however, no unified definition of parent involvement exists. This study examined different understandings and definitions of parent involvement in a sample of administrators of…
Gracitelli, Carolina P. B.; Abe, Ricardo Y.; Diniz-Filho, Alberto; Vaz-de-Lima, Fabiana Benites; Paranhos, Augusto; Medeiros, Felipe A.
Schizophrenia is a complex mental disorder associated with not only cognitive dysfunctions, such as memory and attention deficits, but also changes in basic sensory processing. Although most studies on schizophrenia have focused on disturbances in higher-order brain functions associated with the prefrontal cortex or frontal cortex, recent investigations have also reported abnormalities in low-level sensory processes, such as the visual system. At very early stages of the disease, schizophreni...
Milka, Michał; Mróz, Iwona; Jastrzebska, Maria; Wrzalik, Roman; Dobrowolski, Dariusz; Roszkowska, Anna M; Moćko, Lucyna; Wylegała, Edward
Atomic force microscopy (AFM) allows to examine surface of different biological objects in the nearly physiological conditions at the nanoscale. The purpose of this work is to present the history of introduction and the potential applications of the AFM in ophthalmology research and clinical practice. In 1986 Binnig built the AFM as a next generation of the scanning tunnelling microscope (STM). The functional principle of AFM is based on the measurement of the forces between atoms on the sample surface and the probe. As a result, the three-dimensional image of the surface with the resolution on the order of nanometres can be obtained. Yamamoto used as the first the AFM on a wide scale in ophthalmology. The first investigations used the AFM method to study structure of collagen fibres of the cornea and of the sclera. Our research involves the analysis of artificial intraocular lenses (IOLs). According to earlier investigations, e.g. Lombardo et al., the AFM was used to study only native IOLs. Contrary to the earlier investigations, we focused our measurements on lenses explanted from human eyes. The surface of such lenses is exposed to the influence of the intraocular aqueous environment, and to the related impacts of biochemical processes. We hereby present the preliminary results of our work in the form of AFM images depicting IOL surface at the nanoscale. The images allowed us to observe early stages of the dye deposit formation as well as local calcinosis. We believe that AFM is a very promising tool for studying the structure of IOL surface and that further observations will make it possible to explain the pathomechanism of artificial intraocular lens opacity formation.
Full Text Available This essay was written to discuss the reasoning behind the personal decisions made by 2 current neuro-ophthalmology fellows to pursue neuro-ophthalmology as a career. It is meant to enlighten the reader about what role neuro-ophthalmologists play in clinical practice, what makes neuro-ophthalmology unique to all other sub-specialties, and how this contributes to making neuro-ophthalmology not only one of the most medically interesting, yet rewarding sub-specialties in ophthalmology.
Gracitelli, Carolina P B; Abe, Ricardo Y; Diniz-Filho, Alberto; Vaz-de-Lima, Fabiana Benites; Paranhos, Augusto; Medeiros, Felipe A
Schizophrenia is a complex mental disorder associated with not only cognitive dysfunctions, such as memory and attention deficits, but also changes in basic sensory processing. Although most studies on schizophrenia have focused on disturbances in higher-order brain functions associated with the prefrontal cortex or frontal cortex, recent investigations have also reported abnormalities in low-level sensory processes, such as the visual system. At very early stages of the disease, schizophrenia patients frequently describe in detail symptoms of a disturbance in various aspects of visual perception that may lead to worse clinical symptoms and decrease in quality of life. Therefore, the aim of this review is to describe the various studies that have explored the visual issues in schizophrenia.
Davis, Mary Elizabeth; Francis, Jasmine H
To discuss interprofessional collaboration between the primary oncology clinicians and specialists in the management of immune-related ocular toxicities. Peer-reviewed articles, case reports and systematic reviews. Accurate ophthalmologic assessment is critical for the prevention and treatment of ocular toxicities associated with immunotherapy. Oncology nurses play a key role in early identification and management of ocular symptoms from immunotherapy; early referral to ophthalmic specialists can enhance recovery and preserve sight. Copyright © 2017 Elsevier Inc. All rights reserved.
Pedrosa, Catarina Areias
Full Text Available Objective: To report the clinical presentation of malarial retinopathy in an adult, emphasizing the importance of this diagnosis for the clinical suspicion and prognosis of cerebral malaria. Methods: A 39-year-old caucasian man presented with hemolytic anemia, thrombocytopenia, acidemia and acute renal failure, developing severe encephalopathy. The diagnosis of malaria was done and after systemic stabilization, the patient noticed a central scotoma in the left eye. Ophthalmological examination revealed retinal features of malarial retinopathy. Results: At one-month follow-up, the patient had improved his systemic condition and the left eye scotoma had disappeared. Visual acuity was 20/20 in both eyes and on examination almost all lesions had regressed. Conclusion: Malarial retinopathy is a diagnostic factor and a prognosis indicator of severe infection, usually with brain involvement. The knowledge of the ophthalmological features associated with severe malaria, which is more frequent in children but can also occur in adults, becomes imperative in order to reduce the risk of neurologic sequelae and associated mortality.
Hilkert, Sarah M; Cebulla, Colleen M; Jain, Shelly Gupta; Pfeil, Sheryl A; Benes, Susan C; Robbins, Shira L
As the ophthalmology accreditation system undergoes major changes, training programs must evaluate residents in the 6 core competencies, including appropriately communicating bad news. Although the literature is replete with recommendations for breaking bad news across various non-ophthalmology specialties, no formal training programs exist for ophthalmology. There are many valuable lessons to be learned from our colleagues regarding this important skill. We examine the historic basis for breaking bad news, explore current recommendations among other specialties, and then evaluate a pilot study in breaking bad news for ophthalmology residents. The results of this study are limited by a small number of residents at a single academic center. Future studies from multiple training programs should be conducted to further evaluate the need and efficacy of formal communication skills training in this area, as well as the generalizability of our pilot training program. If validated, this work could serve as a template for future ophthalmology resident training and evaluation in this core competency. Copyright © 2016 Elsevier Inc. All rights reserved.
Jay Chhablani; Simon Kaja; Vinay A Shah
The potential usefulness of smartphones in the medical field is evolving everyday. This article describes various tools available on smartphones, largely focusing on the iPhone, for the examination of an ophthalmic patient, for patient and physician education, as well as reference tools for both ophthalmologists and vision researchers. Furthermore, the present article discusses how smartphones can be used for ophthalmic photography and image management, and foremost, the usefulness of the app...
Full Text Available The potential usefulness of smartphones in the medical field is evolving everyday. This article describes various tools available on smartphones, largely focusing on the iPhone, for the examination of an ophthalmic patient, for patient and physician education, as well as reference tools for both ophthalmologists and vision researchers. Furthermore, the present article discusses how smartphones can be used for ophthalmic photography and image management, and foremost, the usefulness of the applications such as the Eye Handbook for the ophthalmologist and interested students, patients, physicians, and researchers, currently available in the iPhone.
Chhablani, Jay; Kaja, Simon; Shah, Vinay A
The potential usefulness of smartphones in the medical field is evolving everyday. This article describes various tools available on smartphones, largely focusing on the iPhone, for the examination of an ophthalmic patient, for patient and physician education, as well as reference tools for both ophthalmologists and vision researchers. Furthermore, the present article discusses how smartphones can be used for ophthalmic photography and image management, and foremost, the usefulness of the applications such as the Eye Handbook for the ophthalmologist and interested students, patients, physicians, and researchers, currently available in the iPhone. PMID:22446908
Elfahsi, A; Oujilal, A; Lahlou, M; Lazrak, A; Kzadri, M
Cherubism is a rare familial fibro-osseous lesion usually observed in children. The diagnosis is clinical and radiological. Outcome is generally favorable, but with a risk of ophthalmologic complications, especially lower eyelid retraction, proptosis, diplopia, displacement of eyeball and loss of visual acuity. Clinicians must be aware of these complications for proper detection and specific treatment. We report a case of cherubism observed in a 10-year-old boy who presented exophthalmia with reduced visual acuity on the right due to reduction of the volume of the orbital cavity and compression of the optic nerve. Partial maxillectomy was required for decompression. Cherubism can lead to various types of ophthalmologic complications. Exophthalmos and loss of visual acuity due to compression of the optic nerve are the most common. Surgery is generally not required, but can become crucial in selected patients.
Borrione, Paolo; Quaranta, Federico; DE Luca, Valeria; Sperandii, Fabio; Ciminelli, Emanuela; Cantera, Emilia; Fagnani, Federica; Pigozzi, Fabio
The aim of the study was to investigate the prevalence and the incidence of ocular complications in contact sport disciplines in a large population of professional and amateur athletes over a period of 3 years. We performed a retrospective review of 694 medical records from athletes examinated from 2008 to 2011. The following data were collected during the routine visit for agonistic sports eligibility: medical history, age, weight, years of sport practice, approximate number of matches, head and eyes injuries during and beyond of the match and a through ocular history. All athletes underwent a detailed ophthalmological evaluation. The follow-up of each athlete was carried out during the following routine visit for agonistic sports eligibility. Most common disorders observed were: peripheral retinal degeneration, blepharitis, conjunctival and corneal diseases with a prevalence of 7%, 4%, 7% and 4% respectively. It was observed a positive correlation between peripheral retinal degeneration and age in amateur male boxers. Moreover, we noticed an incidence of 6% of laser therapeutic treatments as a result of retinal holes or degenerations, during the follow-up. Contact sport disciplines did not result in higher prevalence of severe ocular lesion. Both conjuntival diseases and peripheral retinal degenerations represented the ophthalmologic disorders with the higher prevalence in our sample. In particular, peripheral retinal degeneration is remarkable because of the increased risk of retinal detachment. Dyschromatopsie, even if quite rare, should be considered when analysing the reception of shots, since gloves in most cases are either red or blue.
Schlenker, Matthew B; Manalo, Elbert; Wong, Agnes M F
To evaluate the research productivity of Canadian ophthalmology departments in terms of research volume, impact, funding, and cost-efficiency, and compare these measures with the top 6 U.S. departments. Systemic review. Using the Web of Science, we obtained the number of peer-reviewed research articles and citations in which an author listed an ophthalmology department (or affiliated university or hospital) from 2001 to 2010 in the top 10 ophthalmology and vision sciences journals, as well as the Canadian Journal of Ophthalmology. Federal research funding received from the Canadian Institutes of Health Research and National Institutes of Health was also obtained. The 3 universities that produced the highest number of articles were the University of Toronto (UofT), McGill University, and the University of British Columbia (UBC). UofT also produced the largest number of citations, followed by UBC and Dalhousie University. For the number of citations per article, the top 3 were the University of Ottawa, Dalhousie University, and the University of Calgary. McGill University, the University of Montreal, and UofT received the most federal funding. The 3 Canadian universities with the lowest funding (cost) per article were UofT, UBC, and McMaster University. The top contributors to the Canadian Journal of Ophthalmology from 2001 to 2010 were UofT, the University of Ottawa, and McGill University. Larger Canadian departments tended to generate higher research volume and obtained more federal funding, but smaller departments also contributed significantly, and sometimes surpassed larger departments, in terms of research impact and cost-efficiency. The top 6 U.S. departments generated higher research volume and received more federal research funding than their Canadian counterparts. However, when research impact and cost-efficiency were examined, Canadian departments performed similar to the top U.S. departments. Copyright © 2013 Canadian Ophthalmological Society. Published
Ruggieri, M; Pavone, P; Polizzi, A; Pietro, M Di; Scuderi, A; Gabriele, A; Spalice, A; Iannetti, P
Aims: To study the ophthalmological manifestations in individuals with the typical features of neurofibromatosis type 1 (NF1) circumscribed to one or more body segments, usually referred to as segmental NF1. Methods: Visual acuity and colour tests, visual field examination, slit lamp biomicroscopy of the anterior segment, and a detailed examination of the retina by indirect ophthalmoscopy were performed at diagnosis and follow up in 72 consecutive subjects (29 males, 43 females; aged 1–64 years; mean age 14.6 years) seen at the university departments of paediatrics in Catania and Rome, Italy, during years 1990–2003, who had in restricted body areas: (1) typical pigmentary manifestations of NF1 (café au lait spots and freckling) only (n = 48); (2) NF1 pigmentary manifestations and neurofibromas alone (n = 2); (3) neurofibromas only (n = 15); and (4) plexiform neurofibromas only (n = 7). Results: None of the 72 patients had Lisch nodules in the iris irrespective of age at eye examination or hypertelorism (a “minor” NF1 feature) and none developed typical associated ophthalmological NF1 complications. An additional child had an isolated optic pathways glioma (OPG), which behaved both biologically and radiographically as an NF1 associated OPG. Conclusions: This represents the first systematic study reporting on eye involvement in the largest series of individuals at different ages having segmental NF1. As one of the postulated mechanisms to explain segmental NF1 is somatic mosaicism for the NF1 gene (so far demonstrated only in two patients) the present findings could be explained either by the fact that the eye is too far from the mutated area with NF1 lesions in most cases or by the NF1 (or other “predisposing” or “cooperating”) gene mutation restricted to too few cellular clones or to tissues embryologically different from the eye. PMID:15489488
Ruggieri, M; Pavone, P; Polizzi, A; Di Pietro, M; Scuderi, A; Gabriele, A; Spalice, A; Iannetti, P
To study the ophthalmological manifestations in individuals with the typical features of neurofibromatosis type 1 (NF1) circumscribed to one or more body segments, usually referred to as segmental NF1. Visual acuity and colour tests, visual field examination, slit lamp biomicroscopy of the anterior segment, and a detailed examination of the retina by indirect ophthalmoscopy were performed at diagnosis and follow up in 72 consecutive subjects (29 males, 43 females; aged 1-64 years; mean age 14.6 years) seen at the university departments of paediatrics in Catania and Rome, Italy, during years 1990-2003, who had in restricted body areas: (1) typical pigmentary manifestations of NF1 (cafe au lait spots and freckling) only (n = 48); (2) NF1 pigmentary manifestations and neurofibromas alone (n = 2); (3) neurofibromas only (n = 15); and (4) plexiform neurofibromas only (n = 7). None of the 72 patients had Lisch nodules in the iris irrespective of age at eye examination or hypertelorism (a "minor" NF1 feature) and none developed typical associated ophthalmological NF1 complications. An additional child had an isolated optic pathways glioma (OPG), which behaved both biologically and radiographically as an NF1 associated OPG. This represents the first systematic study reporting on eye involvement in the largest series of individuals at different ages having segmental NF1. As one of the postulated mechanisms to explain segmental NF1 is somatic mosaicism for the NF1 gene (so far demonstrated only in two patients) the present findings could be explained either by the fact that the eye is too far from the mutated area with NF1 lesions in most cases or by the NF1 (or other "predisposing" or "cooperating") gene mutation restricted to too few cellular clones or to tissues embryologically different from the eye.
steroids abuse is common and traditional eye medicines of dubious benefits are in common use. 1n the absence or ophthalmic anti-fungal preparations, vaginal anti-fungal cream is used and most patients complain of increased pains. redness and general discomfort. These lead to poor compliancev. In conclusion despite ...
sacrocoxcygeal region, then the gonads, cervical and retroperitoneal regions of the body.“ 3. Teratomas arising from the head and neck region are uncommon.4 We report a case of ... intestinal glands and neural tissue with retinoblasts showing severe anaplasia. There was local inﬁltration and foei of adipose tissue.
AUli Some workers in Nigeria had also siudied specific forms of ulcerative keratins such as mycotic .... were carried out: foreign body removal. (10 eyes); repeated scraping/debridement in eyes with corneal stromal .... □with corneal ulcers in outdoor workers in. South Africa. '"' None was recorded in this study, While band ...
becoming blind due to primary open angle glaucoma. I In people of African descent, primary open angle ... Results. A total of 54 eyes of 31 patients were recruited for this study. There were 17 males and 14 females .... 4. Miller KN et al. A comparison of total and partial tenectomy with trabeculectomy. Am J. Ophthalmol 1991 ...
E. V. Dovgan’
Full Text Available The data on different antimicrobial agents (fluoroquinolones, minoglycosides, macrolides, fusidic acid, chloramphenicol and their activity against various microorganisms are reviewed. The findings from different researchers are analyzed. Considerable attention is devoted to the problem of antimicrobial resistance in ophthalmology. Pharmacokinetics of topical antimicrobial agents applied in ophthalmology, their safety and tolerability are described. The indications for topical antimicrobial agents use in ophthalmology approved in Russian Federation are presented. With regard for pharmacokinetics and pharmacodynamics, safety profile and good tolerability, it is concluded that fluoroquinolones are medication of choice for empirical antimicrobial treatment in ophthalmology.
Codding, Robin S.; Chan-Iannetta, Lisa; George, Shauna; Ferreira, Kristine; Volpe, Robert
The purpose of this study was to use multilevel modeling to compare the effects of KPALS alone and combined with goal setting and reinforcement to a control condition on early numeracy performance of 96 kindergarteners. Demographic variables were examined as moderators. Results differed according to early numeracy measure, with both versions of…
Erdiller, Z. B.; Dogan, Ö.
The purpose of this study is to examine the level of teacher stress experienced by Turkish early childhood education teachers working in public and private preschools serving children from three to six years of age. The participants of the study include 1119 early childhood education teachers gathered through simple random sampling. The data are…
Azize ATLI ÖZBAŞ
Full Text Available Aim: The aim of this study was to investigate the relationship between early maladaptive schemas and examination anxiety of students who were preparing for university examination. Method: This study was carried out at a private establishment for preparing students for university examination in Ankara. 108 students who were preparing for university examination were recruited. All data were obtained by using Sociodemograpical Questionnaire, State and Trait Anxiety Inventory, and Young Schema Questionnaire Third version, during 1-10 June 2011. Results: Mean age of students was 18.78 ±0.88. 47.2% were female, while 52.8% were male. There was a significant correlation between students’ State Anxiety and Emotional Deprivation (r=0.25; p<0.01, Failure to Achieve (r=0.19;p<0.05, and Subjugation (r=0.27;p<0.01 subscales; Trait Anxiety and Emotional Deprivation (r=0.25;p<0.01, and Subjugation (r=0.27;p<0.01 subscales of Young Schema Questionnaire. Number of siblings was related with Entitlement (OR= -10.1; P=<0.01, importance attributed to examination was related with Failure to Achieve (OR= -7.9; P=<0.05 and Subjugation (OR= -5.8; P=<0.01; while the type of division (Science/ Mathematic-Turkish was related with all schema sub-types (for Emotional Deprivation OR= -11.9, P=<0.01; Failure to Achieve OR= -11.5, P=<0.01; Subjugation OR= -4.7, P=<0.05; Emotional Inhibition OR= -5.9, P=<0.01; and Entitlement OR= -4.5; P=<0.01. Discussion: Early maladaptive schemas may have a significant negative effect on examination anxiety of students whoare preparing for university entrance exam.
Foo, Chee Yoong; Lim, Ka Keat; Sivasampu, Sheamini; Dahian, Kamilah Binti; Goh, Pik Pin
Background Rising demand of ophthalmology care is increasingly straining Malaysia?s public healthcare sector due to its limited human and financial resources. Improving the effectiveness of ophthalmology service delivery can promote national policy goals of population health improvement and system sustainability. This study examined the performance variation of public ophthalmology service in Malaysia, estimated the potential output gain and investigated several factors that might explain the...
Zvornicanin, Edita; Zvornicanin, Jasmin; Hadziefendic, Bahrudin
Smart phones are being increasingly used among health professionals. Ophthalmological applications are widely available and can turn smart phones into sophisticated medical devices. Smart phones can be useful instruments for the practice of evidence-based medicine, professional education, mobile clinical communication, patient education, disease self-management, remote patient monitoring or as powerful administrative tools. Several applications are available for different ophthalmological exa...
Due to its strong vascularization, the eye can be a target organ of systemic diseases. The aim of this prospective study was to examine cats suffering from systemic diseases for acute, pathological, ophthalmological findings. Cats that were presented to the Clinic for Small Animals, Freie Universität Berlin over a period of 36 months suffering certain systemic diseases or defined laboratory abnormalities were examined for ophthalmological changes. The inclusion criteria included evidence of a...
van der Vinne, Vincent; Zerbini, Giulia; Siersema, Anne; Pieper, Amy; Merrow, Martha; Hut, Roelof A; Roenneberg, Till; Kantermann, Thomas
Circadian clocks of adolescents typically run late-including sleep times-yet adolescents generally are expected at school early in the morning. Due to this mismatch between internal (circadian) and external (social) times, adolescents suffer from chronic sleep deficiency, which, in turn, affects academic performance negatively. This constellation affects students' future career prospects. Our study correlates chronotype and examination performance. In total, 4734 grades were collected from 741 Dutch high school students (ages 11-18 years) who had completed the Munich ChronoType Questionnaire to estimate their internal time. Overall, the lowest grades were obtained by students who were very late chronotypes (MSFsc > 5.31 h) or slept very short on schooldays (SDw performance depended on the time of day that examinations were taken. Opposed to late types, early chronotypes obtained significantly higher grades during the early (0815-0945 h) and late (1000-1215 h) morning. This group difference in grades disappeared in the early afternoon (1245-1500 h). Late types also obtained lower grades than early types when tested at the same internal time (hours after MSFsc), which may reflect general attention and learning disadvantages of late chronotypes during the early morning. Our results support delaying high school starting times as well as scheduling examinations in the early afternoon to avoid discrimination of late chronotypes and to give all high school students equal academic opportunities. © 2014 The Author(s).
A series of cures for ophthalmological diseases practised by saints are described, particularly the Saints Cosmas and Damian and the Saints Cyrus and John, the famous 'Anargyroi'. In the xenones of the Byzantine churches and in the hospitals connected to these, therapeutic regimes, cures and surgical interventions took place at night during incubation, following the example of the ancient Asclepieia. This conclusion stands in spite of the fact that the authors describing the lives of the saints were often clergy who frequently cloak the true therapeutical cures by presenting them in a supernatural manner in order to stress the divine intervention of the saints. From the operations mentioned, it is clear that cataract surgery was among the operations most frequently practised.
Engelhard, Stephanie B; Collins, Megan; Shah, Christopher; Sim, Austin J; Reddy, Ashvini K
Understanding outcomes of pediatric malpractice litigation allows ophthalmologists to gain insight into how to best care for patients and prevent such litigation. To report and analyze the causes and outcomes of ophthalmology medical malpractice litigation involving patients younger than 18 years. The WestLaw database was reviewed from April 1 to 30, 2015, for ophthalmology-related lawsuits, including settlements and trial verdicts, in the United States from January 1, 1930, to December 31, 2014. Search terms included ophthalmology or ophthalmologist and malpractice anywhere in the retrieved documents. Cases in which the plaintiffs were younger than 18 years at the time of the inciting event were included. Pediatric cases were compared with adult cases. Pediatric malpractice case outcomes and settlement amounts. Sixty-eight ophthalmology malpractice cases involving plaintiffs younger than 18 years were included in the study. Thirty-five cases (51.5%) were resolved via jury trial. Of these 35 cases, verdicts in favor of the plaintiff were issued in 17 pediatric cases (48.6%), compared with 168 of 584 adult cases (28.8%) (difference, 33%; 95% CI, -24% to 64%; P = .01). The 17 cases that resulted in verdicts in favor of the pediatric plaintiff had a mean jury award of $4 815 693 (median, $883 281; range, $147 765-$42 061 690). Nine of the total 68 cases (13.2%) resulted in a settlement, with mean adjusted indemnities of $1 912 738 (median, $1 377 689; range, $92 070-$8 493 086). The remaining 24 cases (35.3%) involved appellate rulings, pretrial and posttrial relief rulings, and 1 bench verdict. Jury awards were higher in pediatric vs adult cases (difference, $3 422 134; 95% CI, -$3 422 134 to $8 731 916; P = .002), as were indemnity payments (difference, $1 186 757; 95% CI, -$69 074 to $3 342 588; P = .003). Cases involving legal blindness were more likely to result in verdicts in favor of the plaintiff
Arabinosyladenine (Ara-A) is an antiviral compound employed for ophthalmological lesions in the form of a 3 p. cent ointment. This purine nucleoside has been shown to possess antiviral activity against several ADN viruses, including herpes simplex virus, but it is ineffective against ARN viruses. Its action in superficial herpetic keratitis is comparable with that of idoxuridine, tolerance to the two compounds being almost identical. Ara-A is of value for treating superficial keratitis lesions not responding to idoxuridine. The weak intra-ocular penetration of Ara-A explains its lack of efficacy in stromal keratitis and herpetic kerato-uveitis, forms in which certain analogues of Ara-A could be beneficial.
Full Text Available This article discusses the potential effects of a shortened fielding period on an employee survey’s item and index scores and respondent demographics. Using data from the U.S. Office of Personnel Management’s 2011 Federal Employee Viewpoint Survey, we investigate whether early responding employees differ from later responding employees. Specifically, we examine differences in item and index scores related to employee engagement and global satisfaction. Our findings show that early responders tend to be less positive, even after adjusting their weights for nonresponse. Agencies vary in their prevalence of late responders, and score differences become magnified as this proportion increases. We also examine the extent to which early versus late responders differ on demographic characteristics such as grade level, supervisory status, gender, tenure with agency, and intention to leave, noting that nonminorities and females are the two demographic characteristics most associated with responding early.
Full Text Available In case s having early syphilis, cerebro-spinal fluid:(CSF was examined 6 months following pencillin treatment in 1173 cases of which 1 case showed some abnormality. In 1288 cases, CSF examination done at 30 months or later revealed abnormality in 3 cases. The initial diagnosis in these cases was primary syphilis in 2 cases and secondary syphilis in the remaining 2 and these cases had initially been treated with 2.4 MU of benzathine penicillin. These 4 cases were now diagnosed as cases of asymptomatic nourosyphifis and retreated with 9 MU Of procaine penicillin. AU these cases were cured following retreatment. Considering this small number (0.17%, it is considered unessential to examine CSF as a routine in early -syphilis.′ However in cases where the clinical or serological response to treatment is not satisfactory, CSF examination is advisable.
Wood, Evan; Kerr, Thomas; Rowell, Greg; Montaner, Julio S G; Phillips, Peter; Korthuis, P Todd; Simel, David L
Timely identification of human immunodeficiency virus (HIV) infection in adults can contribute to reduced mortality and likelihood of further HIV transmission. During the first 6 months after infection, known as early HIV infection, patients often report a well-described constellation of symptoms and signs. However, the literature examining utility of the clinical examination in identifying early infection has not been systematically assessed. To assess the accuracy of symptoms and signs in identifying early HIV infection among adults. We searched MEDLINE and EMBASE (1981-May, 2014) for articles investigating symptoms and signs of early HIV infection in adults and searched reference lists of retrieved articles. We retained original studies that compared symptoms and signs among patients with early HIV infection in comparison to HIV-negative individuals. Data were extracted and used to calculate sensitivity, specificity, and likelihood ratios (LRs), and meta-analysis was used to calculate summary LRs. Of 1356 studies, 16 studies included data that were eligible for meta-analysis and included a total of 24,745 patients and 1253 cases of early HIV infection. Symptoms that increased the likelihood of early HIV infection the most included genital ulcers (LR, 5.4; 95% CI, 2.5-12), weight loss (LR, 4.7; 95% CI, 2.1-7.2), vomiting (LR, 4.6; 95% CI, 2.5-8.0), and swollen lymph nodes (LR, 4.6; 95% CI, 1.3-8.0). No symptoms had an LR that was 0.5 or lower, but the absence of recent fever (LR, 0.74; 95% CI, 0.64-0.84) slightly decreased the likelihood of early HIV infection. The presence of lymphadenopathy on physical examination was the most useful sign (LR, 3.1; 95% CI, 1.0-5.2). No sign had an LR of 0.5 or less, but the absence of lymphadenopathy slightly decreased the likelihood of early HIV infection (LR, 0.70, 95% CI, 0.49-0.92). Using data from studies that considered combinations of findings (range of possible findings, 4-17), the summary LR for individuals with 0
Tibi, L.; van Oppen, P.; Aderka, I.M.; van Balkom, A.J.L.M.; Batelaan, N.M.; Spinhoven, P.; Penninx, B.W.J.H.; Anholt, G.E.
Past research demonstrated that age at onset might account for different clinical and etiological characteristics in panic disorder (PD). However, prior research relied on arbitrary choices of age cut-offs. Using a data-driven validated method, this study aimed to examine differences between early
Tibi, Lee; van Oppen, Patricia; Aderka, Idan M.; van Balkom, Anton J. L. M.; Batelaan, Neeltje M.; Spinhoven, Philip; Penninx, Brenda W.; Anholt, Gideon E.
Past research demonstrated that age at onset might account for different clinical and etiological characteristics in panic disorder (PD). However, prior research relied on arbitrary choices of age cut-offs. Using a data-driven validated method, this study aimed to examine differences between early
Julius Broto Dewanto
A higher thalassemia knowledge score causes medical students to be willing to undergo thalassemia carrier status examination at an earlier point in timing. A well-organized educational program focusing on thalassemia and early screening in young adults may enhance the thalassemia prevention program.
Dickinson, David K.; McCabe, Allyssa; Anastasopoulos, Louisa
This paper presents a comprehensive framework for examining book use in early childhood settings, including the following dimensions: the book area; the amount of time provided for book reading; integration of books into the broader curriculum; the nature of the book reading events; and the nature of the home-school connection with respect to book…
Tibi, Lee; van Oppen, Patricia; Aderka, Idan M; van Balkom, Anton J L M; Batelaan, Neeltje M; Spinhoven, Philip; Penninx, Brenda W; Anholt, Gideon E
Past research demonstrated that age at onset might account for different clinical and etiological characteristics in panic disorder (PD). However, prior research relied on arbitrary choices of age cut-offs. Using a data-driven validated method, this study aimed to examine differences between early and late onset PD in various determinants. Admixture analysis was used to determine the best fitting model of age at onset distribution in PD. Data was collected from 511 individuals (ages 18-65) with PD diagnoses, who participated in the Netherlands Study of Depression and Anxiety (NESDA). DSM-IV comorbidities and various measures of childhood adversities, suicidal behavior, anxiety and depressive symptoms were assessed. The best fitting cut-off score between early and late age at onset groups was 27 years (early age at onset ≤ 27 years). Univariate tests showed that participants with early onset PD were younger and more likely to be female. Early onset PD was associated with agoraphobia, higher frequency of childhood trauma and life events, and higher rates of suicide attempts as compared to late onset PD. Multivariate logistic regression analysis demonstrated that only current age, childhood trauma and agoraphobia remained significantly associated with early onset PD. Findings suggest that 27 years marks two onset groups in PD, which are slightly distinct. Early onset PD is independently associated with exposure to childhood trauma and increased avoidance. This highlights the importance of subtyping age of onset in PD. Clinical implications are further discussed. Copyright © 2013 Elsevier Ltd. All rights reserved.
Verma, Ishwar Chander; Paliwal, Preeti; Singh, Kanika
The authors review the utility of genetic testing in ophthalmic disorders - precise diagnosis, accurate prognosis, genetic counseling, prenatal diagnosis, and entry into gene-specific therapeutic trials. The prerequisites for a successful outcome of a genetic test are an accurate clinical diagnosis, a careful family history that guides which genes to study, and genetic counseling (both pre-test and post-test). The common eye disorders for which genetic testing is commonly requested are briefly discussed - anophthalmia, microphthalmia, coloboma, anterior segment dysgenesis, corneal dystrophies, cataracts, optic atrophy, congenital glaucoma, congenital amaurosis, retinitis pigmentosa, color blindness, juvenile retinoshisis, retinoblastoma etc. A protocol for genetic testing is presented. If specific mutations in a gene are common, they should form the first tier test, as the mutations in Leber hereditary optic neuropathy. If mutations in one gene are likely, sequencing of that gene should be carried out, e.g. GALT gene in galactosemia, RS1 gene in retinoshisis. Disorders with genetic heterogeneity require multi-gene panel tests, and if these show no abnormality, then deletion / duplication or microarray studies are recommended, followed in sequence by clinical exome (5000 to 6000 genes), full exome (about 20,000 genes or whole genome studies (includes all introns). It is fortunate that most genetic tests in ophthalmology are available in India, including gene panel and whole exome/genome sequencing tests.
Nigerian Journal of Ophthalmology. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 22, No 3 (2014) >. Log in or Register to get access to full text downloads.
Ruggieri, M; PAVONE, P.; Polizzi, A.; Pietro, M. Di; Scuderi, A.; Gabriele, A; Spalice, A.; Iannetti, P
Aims: To study the ophthalmological manifestations in individuals with the typical features of neurofibromatosis type 1 (NF1) circumscribed to one or more body segments, usually referred to as segmental NF1.
Kim, Bo Hee; Yu, Young Suk; Kim, Seong-Joon
Purpose To describe the characteristics and frequency of ophthalmologic findings in patients with Lennox-Gastaut syndrome (LGS). Methods The medical records of patients diagnosed with LGS at Seoul National University Children's Hospital from January 2004 to August 2014 were retrospectively reviewed. The records of 34 patients (mean age ? standard deviation, 2.66 ? 3.51 years; male, 58.8%) were reviewed. The primary measure was the incidence of ophthalmologic manifestations. Results Of the 34 ...
Full Text Available AIM:To identify and categorize ophthalmology-relevant apps for the iPad tablet computer as a source for ophthalmic practices on the Apple's App Store.METHODS: The Apple's App Store was searched for ophthalmology-relevant apps from January 2013 to August 2013. Eligible apps were identified and downloaded into the iPad tablet computers, and then categorized according to the apps' initial contents and our using experiences. Methods about how to use the iPad's built-in functions of instant video call(FaceTime®and automatic data storage technology(iCloud®were also described together with the apps. Other operating systems of Microsoft's Window Phone and Google's Android were also searched for ophthalmology-relevant apps.RESULTS: The keywords for searching on the Apple's App Store were “ophthalmology” and “eye”. And we could found 111 eligible apps with the former keyword, and 452 ones with the latter one. The integrated uses of the iPad tablet computer were then categorized into five aspects. Based on our clinical practice, we finally summarized the advantages and disadvantages of the iPad tablet computer for ophthalmic practices. However, ophthalmology-relevant apps were found to be very limited in number on the other two platforms.CONCLUSION: The integrated use of self built-in apps and third-party apps can facilitate our clinical work in examination, telemedicine, reference, disease education and literature searching. More studies are needed to verify its validation and reliability in the professional fields, especially eye examinations.
Shah, Deepika N.; Huang, Jiayan; Ying, Gui-shuang; Pietrobon, Ricardo; O’Brien, Joan M.
Purpose To examine trends in female first and last authors in clinical ophthalmology literature published from January 2000 to December 2009. Methods A total of 3760 articles in American Journal of Ophthalmology (AJO), 2347 articles in Archives of Ophthalmology (Archives), and 3838 articles in Ophthalmology spanning 10 years of published ophthalmology peer-reviewed literature were examined. All original research articles and brief reports indexed online were included. Author gender was determined by an exhaustive Internet search. Articles were excluded if the sex of the author could not be determined or was not applicable (for example, articles by a study group rather than an individual author). Results Gender information was identified in 86.8% of articles for first authors and 86% for last authors. The number of female first authors (P Ophthalmology. There was a significant correlation between gender of the first author and total number of authors that was not observed with last-author sex. Conclusions Female first authorship has increased from 2000 to 2009 and is correlated with the gender of the last author; however, there were fewer female last authors compared to female first authors in the same period. PMID:24459456
Shah, Deepika N; Huang, Jiayan; Ying, Gui-shuang; Pietrobon, Ricardo; O'Brien, Joan M
To examine trends in female first and last authors in clinical ophthalmology literature published from January 2000 to December 2009. A total of 3760 articles in American Journal of Ophthalmology (AJO), 2347 articles in Archives of Ophthalmology (Archives), and 3838 articles in Ophthalmology spanning 10 years of published ophthalmology peer-reviewed literature were examined. All original research articles and brief reports indexed online were included. Author gender was determined by an exhaustive Internet search. Articles were excluded if the sex of the author could not be determined or was not applicable (for example, articles by a study group rather than an individual author). Gender information was identified in 86.8% of articles for first authors and 86% for last authors. The number of female first authors (P representation increased for last authors significantly only in Ophthalmology. There was a significant correlation between gender of the first author and total number of authors that was not observed with last-author sex. Female first authorship has increased from 2000 to 2009 and is correlated with the gender of the last author; however, there were fewer female last authors compared to female first authors in the same period.
Adachi, M.; Kojima, K.; Hayashi, K.
For the light source of photocoagulators for ophthalmology, orange laser is more suitable than green laser because of low scattering loss by the crystalline lens, and low absorption by xanthophylls in the retina. We developed two orange fiber lasers (580 nm and 590 nm) to investigate the effect depending on the difference in the range of orange. The 580nm laser is composed of a 1160 nm fiber laser and a Periodically Polled Lithium Niobate (PPLN) crystal for second harmonic generation. The 1160 nm fiber laser beam is focused into the MgO-doped PPLN crystal whose length is 30 mm with 3-pass configuration. Continuous-wave 1.3 W output power of 580 nm was obtained with 5.8 W input power of 1160nm for the first time. The conversion efficiency was 22%. The band width of the second harmonic was 0.006 nm (FWHM). The 590 nm laser is almost the same as 580 nm laser source. In this case we used a Raman shift fiber to generate 1180 nm, and the output power of 590 nm was 1.4 W. We developed an evaluation model of photocoagulator system using these two laser sources. A 700 mW coagulation output power was obtained with this orange fiber laser photocoagulator system. This is enough power for the eye surgery. We have the prospect of the maintenance-free, long-life system that is completely air-cooled. We are planning to evaluate this photocoagulator system in order to investigate the difference between the two wavelengths at the field test.
Fraser, J. Alexander; Biousse, Valérie; Newman, Nancy J.
Mitochondrial diseases frequently manifest neuro-ophthalmologic symptoms and signs. Because of the predilection of mitochondrial disorders to involve the optic nerves, extraocular muscles, retina, and even the retrochiasmal visual pathways, the ophthalmologist is often the first physician to be consulted. Disorders caused by mitochondrial dysfunction can result from abnormalities in either the mitochondrial DNA or in nuclear genes which encode mitochondrial proteins. Inheritance of these mutations will follow patterns specific to their somatic or mitochondrial genetics. Genotype-phenotype correlations are inconstant, and considerable overlap may occur among these syndromes. The diagnostic approach to the patient with suspected mitochondrial disease entails a detailed personal and family history, careful ophthalmic, neurologic, and systemic examination, directed investigations, and attention to potentially life-threatening sequelae. Although curative treatments for mitochondrial disorders are currently lacking, exciting research advances are being made, particularly in the area of gene therapy. Leber hereditary optic neuropathy, with its window of opportunity for timely intervention and its accessibility to directed therapy, offers a unique model to study future therapeutic interventions. Most patients and their relatives benefit from informed genetic counseling. PMID:20471050
Kaplan, Lauren M; Greenfield, Thomas K; Karriker-Jaffe, Katherine J
Study aims were to examine: (i) how physical and sexual victimisation in early life are associated with alcohol's harm from others; and (ii) whether respondents' current drinking is a mediator of the association between early life victimisation and alcohol's harm from others among men and women. Data were from national computer-assisted telephone interviews, using the landline sample (3335 men and 3520 women ages ≥18) from the 2010 US National Alcohol Survey. Harms from someone else's drinking included family/marital problems, financial troubles, assault and vandalism in the past 12 months. Victimisation was measured with severe physical abuse or sexual assault before age 18. Severe physical or sexual victimisation before age 18 was reported by 3.4% of men and 8.1% of women. Significantly more men (5.2%) than women (2.4%) reported assault by other drinkers, and significantly more women reported family/marital (5.3%) and financial problems (2.8%) than did men (2.6 and 1% respectively). Severe early life victimisation was robustly associated with a greater likelihood of experiencing past-year harms from other drinkers for both men and women. Men's drinking partially mediated associations between early life victimisation and recent assaults and vandalism by other drinkers. Early life victimisation may increase risk of harms from someone else's drinking. Health services and interventions that screen for histories of victimisation may help decrease risk of later harms from others' drinking. Reductions in drinking among men with histories of victimisation also could help reduce their exposure to such harms. [Kaplan LM, Greenfield TK, Karriker-Jaffe KJ. Examination of associations between early life victimisation and alcohol's harm from others. Drug Alcohol Rev 2017;00:000-000]. © 2017 Australasian Professional Society on Alcohol and other Drugs.
Holliman, A. J.; Gutiérrez Palma, N.; Critten, S.; Wood, C.; Cunnane, H.; Pillinger, C.
This study was designed to examine the independent contribution of prosodic sensitivity--the rhythmic patterning of speech-to word reading and spelling in a sample of early readers. Ninety-three English-speaking children aged 5-6 years old (M = 69.28 months, SD = 3.67) were assessed for their prosodic sensitivity, vocabulary knowledge,…
Emanuela eSaita; Chiara eAcquati; Karen eKayser
The study examines the influence of personality traits and close relationships on the coping style of women with breast cancer. A sample of seventy-two Italian patients receiving treatment for early stage breast cancer was recruited. Participants completed questionnaires measuring personality traits (Interpersonal Adaptation Questionnaire), interpersonal closeness (Inclusion of the Other in the Self Scale), and adjustment to cancer (Mini-Mental Adjustment to Cancer Scale). We hypothesized tha...
Wei, Shi-hui; Zhao, Jia-liang
Neuro-ophthalmology is a medical subspecialty concerned on the nervous system diseases with ocular manifestations, this could be both sensory and motor, including ocular movements, papillary responses, and the structure changes of the brain and nervous system with ocular manifestations. Although neuro-ophthalmology in China has achieved some progress, certain problems still exist, such as the professional neuro-ophthalmology team and related academic organization are still absent in China; neuro-ophthalmology knowledge has not been popularized; the new technologies for diagnosis and treatment in neuro-ophthalmology have not been absorbed and applied; the coordination and cooperation with other related disciplines are not enough. We should actively promote the development of neuro-ophthalmology in China, including organization of a professional team of neuro-ophthalmology, popularization of neuro-ophthalmology knowledge to the ophthalmologists, development of research work in neuro-ophthalmology and the collaboration with international neuro-ophthalmologists.
Kuwano, H; Kitamura, K; Baba, K; Morita, M; Matsuda, H; Mori, M; Sugimachi, K
Determination of the resection line using intraoperative endoscopic examination with Lugol staining was performed when preoperative examinations such as an esophagogram could not be effectively carried out and the carcinoma was not palpable from the outer surface of the esophageal wall. During the past two years, we performed this technique on eight patients. The carcinoma was restricted within the epithelium in one, the mucosal layer in five, and the submucosal layer in two. Although intraepithelial carcinoma contiguous to the main lesion was seen in six and cancer multiplicity was evident in two, all of the resected stumps were free of any cancer tissue. There have been no cases of recurrence and a limited operation, such as distal esophagectomy, was able to be performed in six. Therefore, intraoperative endoscopic examination is useful for early esophageal cancer.
Huang, Grace; Fang, Christina H; Friedman, Remy; Bhagat, Neelakshi; Eloy, Jean Anderson; Langer, Paul D
To examine the relative qualifications of expert witnesses testifying on behalf of plaintiffs vs defendants in ophthalmology malpractice litigation. Correlational and descriptive study; analysis of expert witness and physician demographic data available on several databases. The Westlaw legal database was searched for ophthalmologist expert witness testimony from January 2006 to June 2014. Physician demographic data were used as the main outcome measures, including length of experience, scholarly impact (as measured by the h-index), practice setting, and fellowship training status and were obtained from state medical licensing board sites and online medical facility and practice sites. H-indices were obtained from the Scopus database. Defendant and plaintiff expert witnesses had comparable mean years of experience (32.9 and 35.7, respectively) (P = .12) and scholarly impact (h-index = 8.6 and 8.3, respectively) (P = .42). Cases tended to resolve on the side of the expert witness with the higher h-index (P = .04). Significantly higher proportions of defendant witnesses were in academic practice (P < .05) and underwent fellowship training (P < .001). Ophthalmologist expert witnesses testifying for both plaintiffs and defendants had over 30 years of experience and high scholarly impact. Practitioners testifying on behalf of plaintiffs were statistically less likely to work in an academic setting and have subspecialty training. Scholarly impact of expert witnesses appeared to affect trial outcomes. Surgical societies should stringently police for appropriate expert witness testimony given by both plaintiff and defense experts in malpractice litigation. Copyright © 2015 Elsevier Inc. All rights reserved.
A. V. Tereshchenko
Full Text Available Purpose: Functional results analysis of ophthalmologic help system for premature infants, which includes the full cycle of early revelation, treatment and regular medical check-up activities for patients with ROP in Central region of Russia.Methods: Fields for ROP screening were performed in premature infants medical care units by clinic specialists. Infants with re- vealed ROP were directed to Kaluga Branch of IRtC «Eye Microsurgery» for detailed diagnostic examination and subsequent treatment and monitoring.Results: In 2003-2011 454 fields in Kaluga, tula, Bryansk, and Orel regions were made. 8861 infants were examined. ROP was found in 1834 infants (20.7%. 823 different interventions for infants with active ROP were performed: 737 retinal lasercoagulations, 3-ports vitrectomy — 72, lensvitrectomy — 14. the total efficacy of the treatment was 92.9%.Conclusion: the ophthalmologic help system for premature infants in Central region of Russia combines all directions from de-tailed diagnostic to hich-technology treatment. It allows to reproduce one all over the Russian Federation territory.
A. V. Tereshchenko
Full Text Available Purpose: Functional results analysis of ophthalmologic help system for premature infants, which includes the full cycle of early revelation, treatment and regular medical check-up activities for patients with ROP in Central region of Russia.Methods: Fields for ROP screening were performed in premature infants medical care units by clinic specialists. Infants with re- vealed ROP were directed to Kaluga Branch of IRtC «Eye Microsurgery» for detailed diagnostic examination and subsequent treatment and monitoring.Results: In 2003-2011 454 fields in Kaluga, tula, Bryansk, and Orel regions were made. 8861 infants were examined. ROP was found in 1834 infants (20.7%. 823 different interventions for infants with active ROP were performed: 737 retinal lasercoagulations, 3-ports vitrectomy — 72, lensvitrectomy — 14. the total efficacy of the treatment was 92.9%.Conclusion: the ophthalmologic help system for premature infants in Central region of Russia combines all directions from de-tailed diagnostic to hich-technology treatment. It allows to reproduce one all over the Russian Federation territory.
Full Text Available A wide variety of fundamental reforms in different spheres of Turkey’s institutions were swiftly implemented in a top-down manner in the early years of the Turkish Republic under Atatürk’s leadership. The purpose of this article is to critically examine the alphabet and language reforms put into practice in the years between the 1920s and 1930s. Since an analysis of socio-cultural and socio-political context is fundamental to understanding any reform initiatives, the article examines the alphabet and language reforms within the larger social, cultural, and political context within which they were carried out. In order to evaluate these reforms from a broader perspective, the article also scrutinizes the assumptions, beliefs, ideologies, and goals of those politicians or reformers who implemented them.
Christine E. Moran
Full Text Available American students typically attend kindergarten at the chronological age (CA of five and currently with the implementation of Common Core State Standards, there are expectations that children learn how to read in order to meet these academic standards, despite whether or not they are developmentally ready. This mixed methods study examined age and environmental factors that relate to reading with 83 children from the ages of 4–6½ years. The relationship between developmental age (DA via the Gesell Developmental Observation-Revised and early literacy learning via Marie’s Clay observational tool, Concepts About Print (CAP, were explored. The purpose of the study was to highlight the need for better alignment of educational policies and practices as they relate to child development and to promote more effective synthesis between discoveries in the field of neuroscience about how children learn and what is known about child DAs and stages. The findings revealed a statistically significant relationship between a child’s DA and early literacy learning as measured by the CAP. The descriptive statistics revealed that the DA of the children in this study was younger than their CA. Furthermore, a child’s DA was found to be the strongest predictor of early literacy learning.
Pruchno, Rachel A; Wilson-Genderson, Maureen
Previous research revealed that successful aging includes both objective and subjective dimensions. This longitudinal analysis examines how early life influences and midlife characteristics predict stability and change in successful aging over a 4-year period. Data from 3,379 people living in New Jersey who completed baseline telephone interviews between 2006 and 2008 and follow-up mail surveys in 2011 were analyzed. Latent profile analysis identified people who aged successfully according to both objective and subjective criteria, neither criteria, and one, but not the other criteria. Multinomial logistic regressions analyses focused on the 2,614 people who were successful according to both objective and subjective criteria at baseline. At follow-up, 18.1% people successful at baseline had transitioned out of that status. Characteristics identifiable early in life (gender, race, education, never marrying, incarceration) as well as midlife status (currently married, working), health behaviors (smoking, drinking, body mass index, exercise), and social support distinguished people who continued to age successfully 4 years later from those who did not. Findings suggest that successful aging is a fluid construct and that although some characteristics identifiable early in life predict successful aging, others are dampened by midlife statuses. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: firstname.lastname@example.org.
Jeong, Seong Hwa; Kang, Dae Ryong; Hur, Nam Wook; Kim, Jinheum; Lee, Soon Young; Jung, Sang Hyuk; Nam, Chung Mo
The purposes of this study were to propose a screening schedule for the early detection of breast cancer among Korean women, as based on the statistical model, and to compare the efficacy of the proposed screening schedule with the current recommendations. The development of the screening schedule for breast cancer closely followed the work of Lee and Zelen (1998). We calculated the age-specific breast cancer incidence rate from the Korea Central Cancer Registry (2003), and then we estimated the scheduling of periodic examinations for the early detection of breast cancer, using mammography, and based on the threshold method. The efficacy of the derived screening schedule was evaluated by the schedule sensitivity. For estimating the screening schedule threshold method, we set the threshold value as the probability of being in the preclinical stage at age 35, the sensitivity of mammography as 0.9 and the mean sojourn time in the preclinical stage as 4 years. This method generated 14 examinations within the age interval [40, 69] of 40.0, 41.3, 42.7, 44.1, 45.4, 46.7, 48.0, 49.3, 51.0, 53.2, 55.3, 57.1, 59.0 and 63.6 years, and the schedule sensitivity was 75.4%. The proposed screening schedule detected 85.2% (74.5/87.4) of the cases that could have been detected by annual screening, but it required only about 48.7% (14.0/30.0) of the total number of examinations. We also examined the threshold screening schedules for a range of sensitivities of mammography and the mean sojourn time in the preclinical stage. The proposed screening schedule for breast cancer with using the threshold method will be helpful to provide guidelines for a public health program for choosing an effective screening schedule for breast cancer among Korean women.
Goss, David A
The purpose of this study is to compare citation patterns in the clinical binocular vision literature of optometry and ophthalmology. The author conducted citation analysis of two current clinical binocular vision textbooks from optometry and two from ophthalmology and of articles published in the years 2000 to 2004 in optometry and ophthalmology journals. Topical parameters for inclusion of sources were diagnosis and management of nonstrabismic binocular vision disorders, diagnosis and management of nonpresbyopic ocular accommodation disorders, and procedures for examining such conditions. These topical parameters were chosen because they are areas in which the diagnostic procedures and treatment options available to members of the two professions are not delineated by their respective scopes of practice. The most frequently cited journals in the optometric publications were optometry journals (63% of citations in the optometry textbooks and 58% in the optometry journal articles). The most frequently cited journals in the ophthalmology publications were ophthalmology journals (79% of citations in the ophthalmology textbooks and 49% in the ophthalmology journal articles). Each discipline also cited a greater variety of journals from within its own field than was cited by the other discipline. The journal with the highest total number of citations was Optometry and Vision Science (280) followed by Ophthalmic and Physiological Optics (73), American Journal of Ophthalmology (68), Investigative Ophthalmology and Visual Science (62), and Optometry (61). Optometry and ophthalmology sources show more citations to materials from their own discipline than from their fellow discipline in the area of nonstrabismic binocular vision disorders and nonpresbyopic accommodative disorders. Reasons may include lack of awareness of the literature of the other discipline, bias toward the literature of one's own discipline, or bias against the literature of another discipline. It is
Nigerian Journal of Ophthalmology. Journal Home · ABOUT · Advanced Search · Current Issue · Archives · Journal Home > Vol 19, No 1 (2011) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register. Corneal Intelligence. I Murdoch. Abstract. No Abstract. Full Text:.
Bath, Patricia E.
The high incidence of eye abnormalities among blacks, coupled with the relative unavailability of ophthalmic services, has resulted in excessive rates of blindness otherwise preventable or curable. As a consequence, incidence rates for blindness are higher for the black population than the white population. Statistics show that black children requiring eyeglasses are less likely to receive eyeglasses than similar age-matched white children. In virtually every state surveyed, blacks were more frequently and severely afflicted with eye diseases and were less likely to receive treatment than whites. Yet, no programs exist in any state specifically targeted to promote eye care among blacks and reverse the ever-worsening trend. Additional data characterizing the scope of the problem shall be presented. An initial strategy for approaching the problem, namely, community ophthalmology, has been developed. Community ophthalmology represents a new discipline promoting eye health and blindness prevention through programs utilizing methodologies of public health, community medicine, and ophthalmology. Basically, the use of community ophthalmology strategies is critical to positive out-come, when given a population composed of blacks and other minorities who are chronically underserved with regard to all sectors of health. The evolution and rationale for these concepts are discussed from national, as well as international, perspectives. PMID:423288
Background: The establishment of a credible, defensible and acceptable “formal competency based ophthalmology training curriculum for undergraduate medical and dental students” is fundamental to program recognition, monitoring and evaluation. The University of Zimbabwe College of Health Sciences (UZ-CHS) has ...
Full Text Available This article discusses how to search and access ophthalmology information based on specialized websites and resources by introducing the database, search engines, electronic journals, electronic books and so on. Hope to help ophthalmic practitioners to carry out scientific research and clinical practice.
Anders, M. (Medizinische Akademie Dresden (Germany))
Ophthalmology is the only medical field in which all of the six known therapeutic applications of low temperature are used. The most important indications are discussed with reference to the corresponding device technology developed at the Department of Cryomedicine of the Dresden Academy of Medicine. (orig.)
Proceedings from the Ophthalmological Society of Nigeria Conference, 2014. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL ...
Proceedings from the Ophthalmological Society of Nigeria Conference, 2014. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL ...
Transactions of the Ophthalmological Society of Nigeria: Proceedings of the annual OSN Conference, Jos, Nigeria, August 25–28, 2015. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · AJOL African Journals Online. HOW TO USE AJOL... for Researchers ...
Nigerian Journal of Ophthalmology. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 19, No 1 (2011) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register. Corneal Intelligence. I Murdoch. Abstract. No Abstract.
Full Text Available Objectives : The aim was to assess of the morphology, intensity, and activity of changes in the first ultrasonographic (US examination of hands and feet in patients with early arthritis (lasting up to 12 months who were ultimately diagnosed with rheumatoid arthritis (RA. An attempt was made to demonstrate a correlation between the intensity of lesions in US and selected laboratory parameters. Material and methods : Ultrasonographic examination was performed using a LOGIC GE 500 device on a group of 60 patients with arthritis (46 women, 14 men aged 18–80, previously untreated. In total, 3120 hand and feet joints were examined. The assessment focused on the presence of joint effusion, synovial proliferation and power Doppler signals (assessed on a semi-quantitative scale. Each patient underwent laboratory tests, necessary for making a diagnosis. In order to analyze the correlations between changes in US and laboratory parameters, erythrocyte sedimentation rate (ESR, reactive protein test (CRP, rheumatoid factor (RF, and anti-citrullinated protein antibodies (ACPAs were used. Results : In the study group, the average duration of arthritis symptoms until the first US examination was 5.6 months. Among the 3120 examined hand and foot joints, deviations from the norm appeared in 1093 joints, synovial hypertrophy was found in 471 joints (grade 1 synovial hypertrophy was reported most frequently, while presence of signal in Power Doppler was revealed in 261 joints (grade 1 was observed most frequently. A statistically significant correlation was found between the intensity of changes in Power Doppler and CRP concentration. Conclusions : In patients with increased concentrations of CRP, we may expect arthritis of higher intensity, therefore, in order to prevent the progression of destructive changes, it is necessary to quickly implement effective disease-modifying antirheumatic treatment. The conducted research showed that the activity of joint
Altpeter, E K; Nguyen, N X
There are very few studies on visually impaired children in Germany; therefore, the aim of this study was to investigate the current spectrum of diseases of visually impaired children and the care of these children in schools and kindergartens with aids and integrative support. In a retrospective study all children (n =303) who attended the outpatient department for the visually impaired of the University Eye Hospital Tübingen in 2013 and 2014 were evaluated. The target values were ophthalmological diagnosis, best corrected visual acuity, needs for magnification, prescribed aids, measures for early support and integrative care and inclusion during schooltime. The most frequent diagnosis in this collective which led to visual impairment in children was optic atrophy (22.4%) followed by hereditary retinal dystrophy (18.5%), congenital nystagmus (9.9%), albinism (8.6%), retinopathy of prematurity (ROP, 7.9%), aniridia (4.6%), cerebral visual impairment (CVI, 4.3%) and severe myopia (3%). Of the children 21% suffered from multiple disabilities, 66% were visually impaired (visual acuity ≤0.3 and >0.05), 9% were severely visually impaired (visual acuity ≤0.05) and 6% were legally defined as blind (visual acuity ≤0.02). Of the schoolchildren 52% (n = 241) were able to visit a mainstream school within the framework of integrative care. For 77% of these schoolchildren integrative care was already provided by a special pedagogic institution at the time of presentation for school entry and 73% of all the schoolchildren needed magnifying aids at school: 20% used optical magnifying aids (e.g. reading stones) and 53% needed electronic magnifying aids, such as screen magnifiers or camera reading systems. Particularly for children, the use of magnifying aids for reading is essential for education in schools and 73% of the children used optical or electronic devices for reading. Of the children 52% attended a mainstream school and were additionally supported by special
Zhang, Kaili C.
To examine and identify the current inclusive practices in early childhood educational settings in Hong Kong, this qualitative study looks at the support and educational services available for young children with special needs in Hong Kong mainstream preschools as well as the characteristics of early childhood educational settings that support…
Aloise-Young, Patricia A; Zaleski, Adam C; Swaim, Randall C
The purpose of the present study was to investigate the longitudinal relation between internalizing problem behaviors (measured with the anxious/depressed and somatic complaints subscales of the Achenbach Teacher's Report Form) and self-reported cigarette smoking behavior and intentions during early adolescence. In addition, a possible mediating role of perceived harm was investigated. Sixth graders and their teachers were surveyed in the sixth grade and students were surveyed again in the seventh grade. Smoking behavior and intentions were assessed with five items including lifetime use, 30-day use, tobacco user status (nonsmoker to heavy smoker), and two intentions/behavioral expectations items. In addition to perceived harm from smoking, reasons for smoking and reasons for not smoking were included on the survey. As hypothesized, teacher reports of sixth-grade internalizing problem behaviors were negatively related to seventh-grade smoking behavior and intentions. Moreover, perceived harm from smoking was negatively related to smoking and intentions. The hypothesized mediating role of perceived harm in the internalizing to smoking relationship was not supported. Potential differences in the relation between internalizing and smoking across adolescence are discussed. Specifically, the results of the present study and an examination of prior literature suggest that in early adolescence internalizing problems are negatively related to cigarette smoking, whereas in middle and late adolescence the opposite is true.
Tetzner, Julia; Becker, Michael
Although optimism's beneficial role for various life areas is well documented, previous findings regarding its significance for students' achievement at school are inconclusive. This study examined the relation between optimism and academic achievement in early adolescents. It investigated the functional form of this relation, addressed whether the initial achievement level moderates this association, and compared this with effects on self-esteem. We used a large German sample (N = 6,010; 53.2% females; baseline Mage = 14.1) with two measurement points over a period of 5 months (middle and end of 7th grade). Estimating LOESS curves and latent change-regression models revealed three main findings. (a) Optimism showed a nonlinear association with subsequent changes in academic achievement: Optimism promoted academic achievement, but this positive association reached a plateau in above-average optimism ranges and a minimum value in below-average ranges of optimism. (b) The achievement level at t1 moderated this relation so that high optimism exerted a more positive effect for high-achieving adolescents. (c) By contrast, optimism had an overall positive effect on self-esteem. The results therefore broaden the evidence on benefits of optimism by linking optimism to academic success in early adolescents but indicate only small and nonlinear associations. © 2017 Wiley Periodicals, Inc.
Full Text Available Katja Oshaug, Peder A Halvorsen, Hasse Melbye General Practice Research Unit, University of Tromsø, Tromsø, Norway Background: Although proven to be associated with bronchial obstruction, chest signs are not listed among cues that should prompt spirometry in the early diagnosis of chronic obstructive pulmonary disease (COPD in established guidelines. Aims: We aimed to explore how chest findings add to respiratory symptoms and a history of smoking in the diagnosis of COPD. Methods: In a cross-sectional study, patients aged 40 years or older, previously diagnosed with either asthma or COPD in primary care, answered questionnaires and underwent physical chest examination and spirometry. Results: Among the 375 patients included, 39.7% had forced expiratory volume in 1 second/forced vital capacity <0.7. Hyperresonance to percussion was the strongest predictor of COPD, with a sensitivity of 20.8, a specificity of 97.8, and likelihood ratio of 9.5. In multivariate logistic regression, where pack-years, shortness of breath, and chest findings were among the explanatory variables, three physical chest findings were independent predictors of COPD. Hyperresonance to percussion yielded the highest odds ratio (OR = 6.7, followed by diminished breath sounds (OR = 5.0, and thirdly wheezes (OR = 2.3. These three chest signs also gave significant diagnostic information when added to shortness of breath and pack-years in receiver operating-characteristic curve analysis. Conclusion: We found that chest signs may add to respiratory symptoms and a history of smoking in the diagnosis of COPD, and we conclude that chest signs should be reinstated as cues to early diagnosis of COPD in patients 40 years or older. Keywords: diagnosis, COPD, physical chest examination, spirometry
Shen, Y; Zelen, M
To estimate sensitivities of breast cancer screening modalities and preclinical duration of the disease from eight breast cancer screening clinical trials. Screening programs invariably lead to diagnosis of disease before signs or symptoms are present. Two key quantities of screening programs are the sensitivity of the disease detection modality and the mean sojourn time (MST). The observed screening histories in a periodically screened cohort make it possible to estimate these quantities of interest. We applied recently developed statistical methods to data from eight randomized breast cancer screening trials to estimate the sensitivities of early detection modalities and MST. Moreover, when a screening trial involved two screening modalities, our methods enabled the estimation of the individual sensitivity of each screening modality. We analyzed breast cancer data from several screening trials and have relatively complete data from the Health Insurance Plan (HIP), Edinburgh, and two Canadian studies. The screening sensitivity for mammography, physical examination, and MST were, respectively, HIP: 0.39, 0.47, and 2.5 years; Edinburgh: 0.63, 0.40, and 4.3 years; Canadian (age 40 to 49 at entry): 0.61, 0.59, and 1.9 years; Canadian (age 50 to 59 at entry): 0.66, 0.39, and 3.1 years. The public debate on early breast cancer detection is mainly centered on mammograms. However, the current study indicates that a physical examination is of comparable importance. Cautious interpretation of trial differences is required as a result of various experimental designs and the age dependency of screening sensitivity and MST.
Sreenivasan, P K; Mattai, J; Nabi, N; Xu, T; Gaffar, A
A simple in vivo approach to examine early dental plaque formation in the human mouth and to determine the effects of common dietary and oral hygiene procedures on biofilm formation is reported. A custom designed device that fits securely behind the teeth of the mandibular arch provides a surface for microbial colonization. This device is prepared with denture acrylic and can be repeatedly used by the subject, exposing a large and constant surface area for microbial accumulation. Large numbers of oral bacteria colonized the device by 2 h; these increased significantly by 4 h (P 0.05). Rinsing with mouthrinses formulated with chlorhexidine, cetylpyridinium chloride or triclosan/copolymer significantly inhibited colonization (P < 0.05). A dose-dependent inhibition was noted with chlorhexidine rinses (P < 0.05). Brushing with a triclosan/copolymer dentifrice significantly inhibited microbial colonization compared with a control (P < 0.05). This simple approach was useful for examining the effects of common dietary and oral hygiene procedures. Significant biofilm inhibitory effects were noted with formulations that demonstrated efficacy in previous clinical studies.
Carr, Steven N; Francis, Andrew J P
This study aimed to examine the overall and specific relationship between early maladaptive schemas (EMSs) and personality disorder (PD) symptoms in a non-clinical sample. While a notable previous study has examined the relationship between EMSs and PD symptoms after statistically controlling for gender and within-cluster PD symptoms, they did not control for comorbid axis I and inter-cluster PD symptoms. Hence, we redressed this methodological problem by statistically controlling for these conditions in a series of multiple regressions. In a sample of 178 non-clinical participants, we obtained self-reports of PD symptoms, depression, anxiety, eating disorder, and EMSs. Results of a series of multiple regressions found that EMSs significantly predicted all PD symptoms apart from borderline and antisocial PDs and our hypotheses were largely consistent with hypotheses for cluster A and C PDs. We also found that specific EMSs differentially predicted PD subtypes even after controlling for other PD symptoms, depression, anxiety, and eating disorder symptoms. This study supports the contention that PDs are related to EMSs and there are specific relationships between particular EMSs and particular PDs. 2010 The British Psychological Society.
Ginja, M M D; Gonzalo-Orden, J M; Melo-Pinto, P; Bulas-Cruz, J; Orden, M A; San Roman, F; Llorens-Pena, M P; Ferreira, A J A
To determine the reliability of early passive hip laxity examination in predicting moderate and severe hip dysplasia. The passive hip laxity of 104 Estrela Mountain dogs was evaluated using the Ortolani method, conventional hip-extended radiography and the PennHIP method, when the animals were between four and 12 months of age. After the age of one, dogs were re-examined for hip dysplasia using the Fédération Cynologique Internationale scoring system. The passive hip laxity results were subsequently compared with the Fédération Cynologique Internationale scores for sensitivity, specificity, positive predictive value, negative predictive value and accuracy. The PennHIP method achieved the best results in specificity (93 per cent), positive predictive value (91 per cent) and accuracy (88 per cent), and the Ortolani method was the best in sensitivity (92 per cent) and negative predictive value (92 per cent). The Fédération Cynologique Internationale grades D and E can be predicted with confidence even before animals are one year old.
Laman, Tasha Tropp; Miller, Erin T.; Lopez-Robertson, Julia
This qualitative study examines what early childhood preservice teachers enrolled in a field-based literacy methods course deemed relevant regarding teaching, literacy, and learning. This study is based on postcourse interviews with 7 early childhood preservice teachers. Findings suggest that "contextualized field experiences" facilitate…
Missall, Kristen; Hojnoski, Robin L.; Caskie, Grace I. L.; Repasky, Patrick
Research Findings: Early mathematical skills and knowledge are strongly related to long-term achievement, and yet the knowledge base regarding the mechanisms through which young children develop these skills and knowledge is limited. Although research has examined the relation of the home numeracy environment and children's early mathematics…
Full Text Available Bevacizumab is a full-length, humanized monoclonal antibody directed against all the biologically active isoforms of vascular endothelial growth factor (VEGF-A. The antibody was initially designed and studied as an anti-angiogenic strategy to treat a variety of solid tumors. After approval by the US Food and Drug Administration, bevacizumab gained access into ophthalmology to treat various types of neovascular diseases. Since the first report in 2005 more than 100 publications share the experience with bevacizumab in ophthalmology. Two authors independently assessed the research results from Pubmed to April 2007. The reference list is a selection of key publications related to the issue. Currently, there is no well-designed randomized controlled trial yet to establish the efficacy and safety of intraocular bevacizumab for any ocular disease in spite of its assumed characteristics representing the most cost-effective VEGF inhibitor.
Vela Marín, A C; Seral Moral, P; Bernal Lafuente, C; Izquierdo Hernández, B
Neuro-ophthalmology is a field combining neurology and ophthalmology that studies diseases that affect the visual system and the mechanisms that control eye movement and pupil function. Imaging tests make it possible to thoroughly assess the relevant anatomy and disease of the structures that make up the visual pathway, the nerves that control eye and pupil movement, and the orbital structures themselves. This article is divided into three sections (review of the anatomy, appropriate imaging techniques, and evaluation of disease according to clinical symptoms), with the aim of providing useful tools that will enable radiologists to choose the best imaging technique for the differential diagnosis of patients' problems to reach the correct diagnosis of their disease. Copyright © 2018 SERAM. Publicado por Elsevier España, S.L.U. All rights reserved.
Lambert, Trevor W; Goldacre, Michael J; Bron, Anthony J
Background The paper aims to report trends in career choices for ophthalmology among UK medical graduates. Methods Postal questionnaire surveys were undertaken of qualifiers from all UK medical schools in nine qualification years since 1974. Data were analysed by univariate cross-tabulation. The significance of comparisons between groups of doctors were calculated by the use of chi-squared tests and adjusted residuals. Results Ophthalmology was the first choice of long term career for 2.3% of men and 1.5% of women one year after qualification; 2.0% of men and 1.4% of women three years after; and 1.8% of men and 1.2% of women at five years. Comparing early choices with eventual destinations, 64% who chose ophthalmology in year one, 84% in year three, and 92% in year five eventually practised in the specialty. The concordance between year one choice and eventual destination was higher for ophthalmology than for most other specialties. 'Enthusiasm for and commitment to the specialty' was the most important single factor in influencing career choice. The prospect of good working hours and conditions was also an important influence: it influenced career choice a great deal for a higher percentage of those who chose ophthalmology (66% in the third year) than those who made other surgical choices (23%). Conclusion Those choosing ophthalmology show a high level of commitment to it. Their commitment is strengthened by the prospect of attractive hours and working conditions. Many doctors who become ophthalmologists have already made their choice by the end of their first post-qualification year. PMID:18318905
Wang, Xueyang; Mudie, Lucy; Brady, Christopher J.
Purpose of review Crowdsourcing involves the use of the collective intelligence of online communities to produce solutions and outcomes for defined objectives. The use of crowdsourcing is growing in many scientific areas. Crowdsourcing in ophthalmology has been used in basic science and clinical research, however it also shows promise as a method with wide-ranging applications. This review presents current findings on the use of crowdsourcing in ophthalmology and potential applications in the future. Recent findings Crowdsourcing has been used to distinguish normal retinal images from images with diabetic retinopathy; the collective intelligence of the crowd was able to correctly classify 81% of 230 images (19 unique) for USD$1.10 per eye in 20 minutes. Crowdsourcing has also been used to distinguish normal optic discs from abnormal ones with reasonable sensitivity (83–88%), but low specificity (35–43%). Another study used crowdsourcing for quick and reliable manual segmentation of OCT images. Outside of ophthalmology, crowdsourcing has been used for text and image interpretation, language translation, and data analysis. Summary Crowdsourcing has the potential for rapid and economical data processing. Among other applications, it could be used in research settings to provide the “ground-truth” data, and in the clinical settings to relieve the burden of image processing on experts. PMID:26761188
Full Text Available Western medicine was first introduced to Taiwan by medical missionaries in the mid-19th century. Modernization of medicine was systematically transplanted to Taiwan in the Japanese colonial period, and ophthalmology was established third among hospital departments, following internal medicine and surgery. Dr Hidetaka Yamaguchi, an ophthalmologist, was the first head of the Taihoku Hospital, later known as National Taiwan University Hospital (NTUH; Taipei, Taiwan. Ophthalmologists during the colonial period conducted studies on tropical and infectious eye diseases. After World War II, ophthalmologists at NTUH played an important role in medical education, residency training, studies, and teaching. Dr Yan-Fei Yang established the Taiwan Ophthalmological Society in 1960 and instituted its official journal in 1962. Dr Ho-Ming Lin established the Department of Ophthalmology at the Tri-Service General Hospital in the 1950s and the Veterans General Hospital in the 1960s. Taiwan ophthalmologists eradicated trachoma by 1971. Cataract surgery and penetrating keratoplasty were initially performed in the 1960s. Currently, there are about 1600 ophthalmologists in Taiwan conducting an estimated 120,000 cataract surgeries and 600 corneal transplantations annually. Many subspecialty societies have been established recently that serve to educate Taiwanese ophthalmologists and to connect with international ophthalmic societies. Taiwan ophthalmologists continue to contribute to the advancement of ophthalmic knowledge globally.
Wang, Xueyang; Mudie, Lucy; Brady, Christopher J
Crowdsourcing involves the use of the collective intelligence of online communities to produce solutions and outcomes for defined objectives. The use of crowdsourcing is growing in many scientific areas. Crowdsourcing in ophthalmology has been used in basic science and clinical research; however, it also shows promise as a method with wide-ranging applications. This review presents current findings on the use of crowdsourcing in ophthalmology and potential applications in the future. Crowdsourcing has been used to distinguish normal retinal images from images with diabetic retinopathy; the collective intelligence of the crowd was able to correctly classify 81% of 230 images (19 unique) for US$1.10/eye in 20 min. Crowdsourcing has also been used to distinguish normal optic discs from abnormal ones with reasonable sensitivity (83-88%), but low specificity (35-43%). Another study used crowdsourcing for quick and reliable manual segmentation of optical coherence tomography images. Outside of ophthalmology, crowdsourcing has been used for text and image interpretation, language translation, and data analysis. Crowdsourcing has the potential for rapid and economical data processing. Among other applications, it could be used in research settings to provide the 'ground-truth' data, and in the clinical settings to relieve the burden of image processing on experts.
Ajay, K.; Krishnaprasad, R.
Background and Aims: This study documents a survey of final-year ophthalmology postgraduate students on the subject of their residency training. A similar survey conducted 7 years ago published in IJO had concluded that the residency program was not up to expectations in many centers. Our study aimed to see if ophthalmology training and student perceptions differed since then. Materials and Methods: For our study, we added a few questions to the same questionnaire used in the article “which is the best method to learn ophthalmology? Resident doctors’ perspective of ophthalmology training” published in IJO, Vol. 56 (5). Results: Forty-nine students (62.02%) returned completed forms. Most students desired an orientation program on entering residency, and wished to undergo diagnostic training initially. Case-presentation with demonstration and Wet-lab learning were most preferred. There was a big difference between the number of surgeries students actually performed and the number they felt would have been ideal. Conclusion: On the whole, the students still felt the need for improved training across all aspects of ophthalmology. PMID:25116778
Limeira-Soares Paulo Henrique
Full Text Available PURPOSE: To determine the retention of knowledge along the years after certification of physicians as ophthalmology specialists. METHODS: The physicians, former ophthalmology residents, were selected at the Department of Ophthalmology, State University of Campinas, São Paulo, Brazil, and randomly allocated to three groups of seven individuals, according to the time as specialists. Group 1 consisted of one-year specialists, group 2 of five-year specialists and group 3 of ten-year specialists. Each participant answered a test with twenty-five multiple choice randomly selected questions, based on the national certificate tests applied by the Brazilian Ophthalmology Council between 1994 and 2003. Each question scored four points. RESULTS: The mean age of groups 1, 2 and 3 was 27, 30 and 36 years, respectively. A preponderance of males was found in all groups. Group 1 achieved the highest score, average of 88, group 2 achieved 77, and group 3 achieved the lowest, average of 64 (p<0,05. CONCLUSION: Loss of knowledge retention amongst specialists of the Brazilian Ophthalmology Council, has been observed along the years after the certification.
Full Text Available Background and Aims: This study documents a survey of final-year ophthalmology postgraduate students on the subject of their residency training. A similar survey conducted 7 years ago published in IJO had concluded that the residency program was not up to expectations in many centers. Our study aimed to see if ophthalmology training and student perceptions differed since then. Materials and Methods: For our study, we added a few questions to the same questionnaire used in the article "which is the best method to learn ophthalmology? Resident doctors′ perspective of ophthalmology training" published in IJO, Vol. 56 (5. Results: Forty-nine students (62.02% returned completed forms. Most students desired an orientation program on entering residency, and wished to undergo diagnostic training initially. Case-presentation with demonstration and Wet-lab learning were most preferred. There was a big difference between the number of surgeries students actually performed and the number they felt would have been ideal. Conclusion: On the whole, the students still felt the need for improved training across all aspects of ophthalmology.
Reininga, J K; Los, L I; Wulffraat, N M; Armbrust, W
OBJECTIVE: The aims of this study are to examine in our juvenile idiopathic arthritis (JIA) population: 1) the prevalence and characteristics of uveitis, 2) the complications and outcome of uveitis, 3) prognostic factors, and 4) the adequacy of the current ophthalmologic screening guidelines.
Elsa Lisset Arredondo Torres
Full Text Available Se realizó una revisión bibliográfica acerca de la personalidad y la obra del científico camagüeyano Carlos Juan Finlay Barré, para ampliar y profundizar los conocimientos de médicos generales y oftalmólogos. En síntesis, se describe la vida de quien realizó trascendentales contribuciones a la medicina universal. Como sus descubrimientos sobre la fiebre amarilla irradian un conocimiento científico tan elevado, es necesario escudriñar sus aportes a la oftalmología. Se destacan algunos de los aportes más relevantes y de forma precisa se hace referencia a varios estudios realizados por él, así como la descripción de su técnica para la cirugía de catarata.A bibliographical revision on Carlos Juan Finlay Barré’s life and work was carried out to widen and deepen knowledge on general medicine and ophthalmology. In short, the life of man who made significant contributions to universal medicine is herein described. As his discoveries about the yellow fever have provided prominent scientific knowledge, so it is necessary to examine his contributions to ophthalmology. Some of his more relevant contributions and studies are also pointed out, as well as the description of his technique for cataract surgery.
Krabben, A; Stomp, W; Huizinga, T W J; van der Heijde, D; Bloem, J L; Reijnierse, M; van der Helm-van Mil, A H M
MRI is increasingly used to measure inflammation in rheumatoid arthritis (RA) research, but the correlation to clinical assessment is unexplored. This study determined the association and concordance between inflammation of small joints measured with MRI and physical examination. 179 patients with early arthritis underwent a 68 tender joint count and 66 swollen joint count and 1.5T MRI of MCP (2-5), wrist and MTP (1-5) joints at the most painful side. Two readers scored synovitis and bone marrow oedema (BME) according to the OMERACT RA MRI scoring method and assessed tenosynovitis. The MRI data were first analysed continuously and then dichotomised to analyse the concordance with inflammation at joint examination. 1790 joints of 179 patients were studied. Synovitis and tenosynovitis on MRI were independently associated with clinical swelling, in contrast to BME. In 86% of the swollen MCP joints and in 92% of the swollen wrist joints any inflammation on MRI was present. In 27% of the non-swollen MCP joints and in 66% of the non-swollen wrist joints any MRI inflammation was present. Vice versa, of all MCP, wrist and MTP joints with inflammation on MRI 64%, 61% and 77%, respectively, were not swollen. BME, also in case of severe lesions, occurred frequently in clinically non-swollen joints. Similar results were observed for joint tenderness. Inflammation on MRI is not only present in clinically swollen but also in non-swollen joints. In particular BME occurred in clinically non-inflamed joints. The relevance of subclinical inflammation for the disease course is a subject for further studies. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Full Text Available The study examines the influence of personality traits and close relationships on the coping style of women with breast cancer. A sample of seventy-two Italian patients receiving treatment for early stage breast cancer was recruited. Participants completed questionnaires measuring personality traits (Interpersonal Adaptation Questionnaire, interpersonal closeness (Inclusion of the Other in the Self Scale, and adjustment to cancer (Mini-Mental Adjustment to Cancer Scale. We hypothesized that diverse personality traits and degrees of closeness contribute to determine the coping styles shown by participants. Multiple regression analyses were conducted for each of the five coping styles (Helplessness/Hopelessness, Anxious Preoccupation, Avoidance, Fatalism, and Fighting Spirit using personality traits and interpersonal closeness variables (Strength of Support Relations, and Number of Support Relations as predictors. Women who rated high on assertiveness and social anxiety were more likely to utilize active coping strategies (Fighting Spirit. Perceived strength of relationships was predictive of using an active coping style while the number of supportive relationships did not correlate with any of the coping styles. Implications for assessment of breast cancer patients at risk for negative adaptation to the illness and the development of psychosocial interventions are discussed.
Tenenbaum-Katan, Janna; Hofemeier, Philipp; Sznitman, Josué; Janna Tenenbaum-Katan Team
Inhalation therapy is the cornerstone of early-childhood respiratory treatments, as well as a rising potential for systemic drug delivery and pulmonary vaccination. As such, indispensable understanding of respiratory flow phenomena, coupled with particle transport at the deep regions of children's lungs is necessary to attain efficient targeting of aerosol therapy. However, fundamental research of pulmonary transport is overwhelmingly focused on adults. In our study, we have developed an anatomically-inspired computational model of representing pulmonary acinar regions at several age points during a child's development. Our numerical simulations examine respiratory flows and particle deposition maps within the acinar model, accounting for varying age dependant anatomical considerations and ventilation patterns. Resulting deposition maps of aerosols alter with age, such findings might suggest that medication protocols of inhalation therapy in young children should be considered to be accordingly amended with the child's development. Additionally to understanding basic scientific concepts of age effects on aerosol deposition, our research can potentially contribute practical guidelines to therapy protocols, and its' necessary modifications with age. We acknowledge the support of the ISF and the Israeli ministry of Science.
Lu, W.; de Bock, G.H.; Schaapveld, M.; Baas, P.C.; Wiggers, T.; Jansen, L.
PURPOSE: Routine physical examination is recommended in follow up guidelines for women with a history of breast cancer. The objective of this paper is to assess the contribution of routine physical examination in addition to mammography in the early diagnosis of breast cancer recurrences. PATIENTS
van Roekel, Eeske; Verhagen, Maaike; Engels, Rutger C M E; Scholte, Ron H J; Cacioppo, Stephanie; Cacioppo, John T
According to the differential reactivity hypothesis, lonely individuals respond differently to their environment compared to nonlonely individuals, which may sustain their loneliness levels. However, this interesting hypothesis has not yet been explored in daily life: Do lonely individuals feel lonely all the time, or do they feel more or less lonely in specific social contexts? The main aim of the present study was to test the differential reactivity hypothesis in daily life by examining in three samples whether trait levels of loneliness affected the levels of state loneliness in different social contexts. We used baseline questionnaires to measure trait loneliness and the Experience Sampling Method to collect data on state loneliness, in early adolescents (N = 269, Mage = 14.49, 59% female) and late adolescents (N = 223, Mage = 19.60, 91% female) from the Netherlands and late adolescents from the United States (N = 126, Mage = 19.20, 51% female). Results provided evidence for the differential reactivity hypothesis in the total sample, as high lonely adolescents experienced higher levels of state loneliness in situations in which they were alone than low lonely adolescents, but also benefited more from being with intimate company than low lonely adolescents. In sum, the present study provided evidence for the differential reactivity hypothesis and showed that the experience of loneliness in daily life was remarkably similar across age and culture. Our findings provide important insights into the daily experiences of trait lonely people, which may provide starting points for interventions.
This study investigated views about children experiencing homelessness held by preservice teachers in an early childhood education program. Thirteen early childhood preservice teachers were actively involved in class discussion, reading, doing class assignments, and visiting homeless shelters as community-based field experience. They were asked to…
Faria, Ann-Marie; Hawkinson, Laura E.; Greenberg, Ariela C.; Howard, Eboni C.; Brown, Leah
Documenting and improving early childhood program quality is a national priority, leading to a rapid expansion of Quality Rating and Improvement Systems (QRISs). QRISs document and improve the quality of early childhood education programs and provide clear information to families about their child care choices. The current study described how…
Samiei, Shahin; Bush, Andrew J.; Sell, Marie; Imig, Doug
This study evaluated participation in the "Imagination Library" early childhood literacy enrichment program and children's pre-literacy and pre-numeracy skills at kindergarten entry in an urban school district. Previous studies have demonstrated that program participation is associated with greater early childhood reading practices.…
Ratcliff, Nancy J.; Jones, Cathy R.; Vaden, S. Russell; Sheehan, Heather; Hunt, Gilbert H.
Millions of dollars are expended, in the USA and elsewhere, to provide paraprofessionals or "teaching assistants" for regular early childhood classrooms. However, little consistent information exists related to best practice in the use of paraprofessionals in these early childhood settings. This article describes a study employing the use of 159…
Norwalk, Kate E.; DiPerna, James C.; Lei, Pui-wa; Wu, Qiong
The purpose of the present study was to determine whether there are systematic differences in literacy skills among children from less-advantaged households, using latent profile analysis. Early reading skills were measured using the Early Arithmetic, Reading, and Learning Indicators (EARLI; DiPerna, Morgan, & Lei, 2007) literacy tasks.…
Lucero, Jessica L.; Barrett, Courtenay; Jensen, Hilary
Early delinquency has received considerably less scholarly attention than adolescent delinquency. Early delinquency is of great concern to school social workers, as it may lead to problematic behaviors in adolescence and future involvement with the juvenile justice system. Using an ecological framework, authors used data from the Fragile Families…
Full Text Available Aims. (1 To assess the efficacy and safety of pediatric office-based sedation for ophthalmologic procedures using a pediatric sedation service model. (2 To assess the reduction in hospital charges of this model of care delivery compared to the operating room (OR setting for similar procedures. Background. Sedation is used to facilitate pediatric procedures and to immobilize patients for imaging and examination. We believe that the pediatric sedation service model can be used to facilitate office-based deep sedation for brief ophthalmologic procedures and examinations. Methods. After IRB approval, all children who underwent office-based ophthalmologic procedures at our institution between January 1, 2000 and July 31, 2008 were identified using the sedation service database and the electronic health record. A comparison of hospital charges between similar procedures in the operating room was performed. Results. A total of 855 procedures were reviewed. Procedure completion rate was 100% (C.I. 99.62–100. There were no serious complications or unanticipated admissions. Our analysis showed a significant reduction in hospital charges (average of $1287 per patient as a result of absent OR and recovery unit charges. Conclusions. Pediatric ophthalmologic minor procedures can be performed using a sedation service model with significant reductions in hospital charges.
Gold, Daniel R; Zee, David S
This review summarizes topical papers from the fields of neuro-ophthalmology and neuro-otology published from August 2013 to February 2015. The main findings are: (1) diagnostic criteria for pseudotumor cerebri have been updated, and the Idiopathic Intracranial Hypertension Treatment Trial evaluated the efficacy of acetazolamide in patients with mild vision loss, (2) categorization of vestibular disorders through history and ocular motor examination is particularly important in the acute vestibular syndrome, where timely distinction between a central or peripheral localization is essential, (3) the newly described "sagging eye syndrome" provides a mechanical explanation for an isolated esodeviation that increases at distance in the aging population and (4) eye movement recordings better define how cerebellar dysfunction and/or sixth nerve palsy may play a role in other patients with esodeviations that increase at distance.
van der Vinne, Vincent; Zerbini, Giulia; Siersema, Anne; Pieper, Amy; Merrow, Martha; Hut, Roelof A.; Roenneberg, Till; Kantermann, Thomas
Circadian clocks of adolescents typically run lateincluding sleep timesyet adolescents generally are expected at school early in the morning. Due to this mismatch between internal (circadian) and external (social) times, adolescents suffer from chronic sleep deficiency, which, in turn, affects
Recent studies have shown that transient early-life exposure to dichloroacetic acid (DCA), a pyruvate analog and metabolic reprogramming agent, increases liver cancer incidence in older mice. This carcinogenic effect is not associated with direct mutagenicity, persistent cytotoxi...
Yousuf, Salman J.; Kwagyan, John; Jones, Leslie S.
Objective To determine the factors most important to applicants when selecting an ophthalmology residency program. Design Cross-sectional survey. Participants All 595 applicants who submitted a rank list to the Ophthalmology Residency Matching Program for the 2012 match. Methods Participants anonymously completed a 25-item questionnaire after the submission of their rank lists. A multiple-choice format and ordinal scale were used to query applicants on demographics, career plans, and the importance of factors related to program characteristics. One question allowed a free text response to identify factors that caused the applicant to rank a program lower than other programs or not at all (i.e., “red flag”). Main Outcome Measures Factors important to applicants when creating their rank lists. Results The response rate was 37% (218/595). The 3 most important factors affecting rank lists were resident–faculty relationships, clinical and surgical volume, and diversity of training. The fourth most important was the interview experience with faculty; poor interview experience was the most frequently cited “red flag.” Age, gender, and marital status did not affect how applicants rated factors. Applicants planning a post-residency fellowship or an academic career placed greater importance on opportunities for resident research and a program's prestige (Pophthalmology residency program. Future career plans and demographic factors influenced the rating of specific factors. The results of this study provide a useful resource to programs preparing for the match. PMID:23084123
Until the beginning of the 17th century it was held that an image is formed in the eye on the anterior surface of the crystalline lens. Ophthalmological optics as a scientific discipline only began with a discovery made by Johannes Kepler. Without performing new experiments, and solely by application of the laws of light refraction, he analyzed the path of light through the eye and demonstrated that an image is formed on the retina and that it is inverted. Acceptance of this discovery was impeded by contemporary prejudices which could imagine nothing but an upright image in the eye, even though this attitude could not explain certain phenomena. Kepler's discovery of the path of light in the eye made it possible to explain the following physical phenomena: central visual acuity, visual field, dark adaptation, and errors of refraction. Physiological diplopia and the mechanism of accommodation were discovered later. The law stating that the intensity of light decreases with the square of distance was also formulated by Johannes Kepler; this law, too, could only be demonstrated after the path of light through the eye had been discovered. In recent years the Keplerian telescope has assumed a practical significance in ophthalmological optics. As a reading aid for individuals with impaired vision it offers a significantly higher magnification than any other optical visual aid.
Soyuncu, S; Cete, Y; Bozan, H; Kartal, M; Akyol, A J
To determine the accuracy of physical examination and ultrasonographic evaluation performed by emergency physicians in cases of blunt abdominal trauma for the early diagnosis of intraabdominal haemorrhage. In this clinical prospective study, trauma patients were evaluated with four-quadrant ultrasonography by emergency physicians after initial stabilisation and physical examination. Diagnoses based on demographic data, physical examination and emergency physician's ultrasonography were compared with the subsequent clinical course. A total of 442 patients participated in the study. The sensitivity and specificity of emergency physician's ultrasonographic examination to detect intraabdominal haemorrhage were 86 and 99%, respectively. Pre-test sensitivity and specificity of physical examination to detect intraabdominal haemorrhage were 39 and 90%, respectively. Physical examination was not a reliable method to detect intraabdominal haemorrhage in cases of blunt abdominal trauma. In contrast, abdominal ultrasonography performed by emergency physicians was a reliable diagnostic tool. Emergency physicians should be familiar with abdominal ultrasonographic examination, which should be routine in cases of blunt abdominal trauma.
O. M. Panko
Full Text Available In the article the ethical and deontological dominants as scientific and practical strategy that prevents the medical errors, and humanization doctor-patient relationship through a formation of culture of communication are presented. Ophthalmology as a branch of practical and scientific medicine requires special relationship between doctor and patient, and because of this it also requires particular ethical and deontological interpretation. Formal signs of ethics laws concerning ophthalmic practice aren’t worth anything in case of unskilled diagnosis and treatment. Possibility of errors on the part of the doctor-ophthalmologist while aiding a patient is of a special importance. In planed and in urgent cases irreparable flaws are not excluded. Consideration should be given, in particular, to the errors in the initial examination, insufficient amount of additional methods of examination, overdiagnosis, errors in determining the treatment strategy (conservative or surgical and others. Identification and analysis of the errors in order to prevent them is the ethical imperative in medical practice and effective way to improve clinical medicine. The author of the article describes the causes of errors, indicating that they are objective and subjective. The first are related to the change of views on the treatment of a certain disease. The complex of therapeutic measures, that was considered the most rational until recently, can be proven as wrong from the perspective of the latest achievements of science. Mistakes made by doctors in their communication with patients as a result of not following the basic deontological principles are also included here. In addition, the classification of medical errors on deontological, diagnostic, therapeutic is made and their essence is analyzed in the article. The violation of the principles of appropriate behavior of the doctor in treating the patient, that is not following the ethics of medical practice by the
To examine the ability of recent Canadian ophthalmology graduates to commence clinical practice and obtain surgical privileges. A secondary objective was to assess their perception of the adequacy of their residency training. An Internet questionnaire survey. Canadian graduates of Canadian ophthalmology residency programs between 2005 and 2009, inclusive. Email addresses for the participants were obtained from the Canadian Ophthalmological Society and invitations to participate were sent, followed by 2 reminder emails. A 44% response rate was obtained (65 out of 154 emails sent). Of the respondents, 91% were working full time, and 89% had operating-room time. Training was adequate for all CanMEDs competencies except working as a manager. Assessment that one's practice did not live up to expectations correlated with male gender, dissatisfaction with location, inability to get operating-room time, inability to get other hospital resources, feelings about fairness of distribution of resources, and net income below expectations. For the most part, recent graduates are successful in establishing practices that meet their expectations. Training in management skills should be improved in residency programs. Copyright © 2012 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.
Full Text Available Objectives: Ophthalmologic disease in patients with acute leukemia occurs due to primary leukemic infiltration (involvement, or secondary to the disease and its treatment. In recent years the life expectancy of acute leukemia patients has increased with the advent of modern therapies. The present study aimed to determine the incidence of ocular manifestations in children with acute leukemia. Materials and Methods: The study included 120 patients diagnosed with acute leukemia at Başkent University Hospital, Pediatric Hematology Department between 1995 and 2010. All the patients were examined by an ophthalmologist via direct and indirect ophthalmoscopy. Results: Among the patients, 83 (69.2% were diagnosed with acute lymphoblastic leukemia, 35 (29.1% with acute myeloblastic leukemia, and 2 (1.7% with mixed-lineage leukemia. In all, 58 ophthalmic manifestations were noted in 41 patients (34.2%. In our patients, 12 ophthalmologic involvements were present at admission and 46 ocular findings occurred during follow-up. The incidence of these manifestations increased with age. Conclusion: Ophthalmologic manifestations were not correlated with gender, hematological parameters at disease onset, type of leukemia, or the frequency of relapse and survival. To more clearly determine the effect of ophthalmologic manifestations on the prognosis of leukemia, larger scale and multi-center studies are needed
McCord, Sarah A; Lynch, Mary G; Maa, April Y
In 2015, a tele-ophthalmology program was undertaken at the Atlanta Veterans Affairs Medical Center to provide screening eye care for veterans in their primary care clinics. Though this program was developed as a screening tool, the availability of these services in primary care clinics has enabled triage of certain acute eye complaints. These case reports describe two patients who were diagnosed with retinal detachments through this program, although their primary care providers had triaged them as requiring non-urgent referrals to the eye clinic. Although many patients are seen for acute ocular complaints in primary care clinics and emergency departments, providers in such settings may lack the ability to adequately examine eyes and thus triage ocular complaints. These cases demonstrate the ability of tele-ophthalmology to assist in diagnosing urgent ocular conditions in primary care clinics. Though tele-ophthalmology has been accepted in some parts of the world, in the United States of America it remains widely underutilized. These cases highlight the ability of tele-ophthalmology to close the gap in acute eye care coverage that exists in the USA, most prominently in rural regions.
Orhan, Betül; Malbora, Barış; Akça Bayar, Sezin; Avcı, Zekai; Alioğlu, Bülent; Özbek, Namık
Ophthalmologic disease in patients with acute leukemia occurs due to primary leukemic infiltration (involvement), or secondary to the disease and its treatment. In recent years the life expectancy of acute leukemia patients has increased with the advent of modern therapies. The present study aimed to determine the incidence of ocular manifestations in children with acute leukemia. The study included 120 patients diagnosed with acute leukemia at Başkent University Hospital, Pediatric Hematology Department between 1995 and 2010. All the patients were examined by an ophthalmologist via direct and indirect ophthalmoscopy. Among the patients, 83 (69.2%) were diagnosed with acute lymphoblastic leukemia, 35 (29.1%) with acute myeloblastic leukemia, and 2 (1.7%) with mixed-lineage leukemia. In all, 58 ophthalmic manifestations were noted in 41 patients (34.2%). In our patients, 12 ophthalmologic involvements were present at admission and 46 ocular findings occurred during follow-up. The incidence of these manifestations increased with age. Ophthalmologic manifestations were not correlated with gender, hematological parameters at disease onset, type of leukemia, or the frequency of relapse and survival. To more clearly determine the effect of ophthalmologic manifestations on the prognosis of leukemia, larger scale and multi-center studies are needed.
Boulanger-Scemama, Elise; Fardeau, Christine; Straus, Christian; Simon, Claude; Touitou, Valérie; Touhami, Sara; Amini, Maryam; Similowski, Thomas; LeHoang, Phuc
Congenital central hypoventilation syndrome (CCHS) is a rare dysgenetic form of neurocristopathy associated with dysfunction of the autonomic nervous system. Ophthalmologic abnormalities are reported in CCHS children, and range from pupillary and iris abnormalities to ptosis, strabismus and convergence deficiency. Since earlier CCHS diagnosis and multidisciplinary management, combined with improved ventilatory support techniques, the lifespan of children with CCHS has been considerably lengthened. The oldest of them have now reached adult age and we report in this study the results of their ophthalmologic examination. Nine CCHS adult patients were prospectively included during a 14-month period. Each patient underwent complete ophthalmologic examination, static pupillometry with scotopic and photopic pupillary diameter (PD) measures, Humphrey 24-2 visual field analysis, macular OCT and complete orthoptic assessment including a Hess-Lancaster test. Ophthalmologic abnormalities were found in six of the nine patients (66%). The main features were strabismus in six patients (66%). Four patients (44%) displayed abnormal pupillary function, with a decrease in average scotopic PD (3.8 ± 1.4 mm), average photopic PD (3.5 ± 1.2 mm), and average percentage of pupillary constriction (7.6 ± 8.5%). Three patients (33%) exhibited iris abnormalities such as iris atrophy, smooth iris surface and atrophic sphincter. This study allowed the description of ophthalmologic abnormalities occurring in CCHS in a series of adult patients, thus improving current knowledge of the disease. The prevalence of pupillary and iris lesions were lower than those observed in a series of children, suggesting that they could be considered as systemic disease severity markers.
Ikeda, Jamie; Davitt, Bradley V.; Ultmann, Monica; Maxim, Rolanda; Cruz, Oscar A.
Purpose: To determine the incidence of ophthalmologic disorders in children with autism and related disorders. Design: Retrospective chart review. Four hundred and seven children diagnosed with autism or a related disorder between 1998 and 2006. One hundred and fifty-four of these children completed a comprehensive ophthalmology exam by a…
Schlötzer-Schrehardt, U; Cursiefen, C
Experimental basic research provides the foundations for the elucidation of pathophysiological mechanisms of diseases and the development of novel diagnostic and therapeutic strategies for ophthalmological diseases. The objective of this contribution is to provide an overview of the international interconnection of basic research in ophthalmology in Germany. The international context of ophthalmological research conducted in Germany is presented by means of personal experiences and data published by the German Ophthalmological Society (DOG), the German Research Foundation (DFG) and the European Union (EU). Due to the lack of organized databases this article lays no claim to completeness. Basic research in ophthalmology in Germany is mainly conducted in university eye departments and is mainly related to the etiology, pathophysiology and therapy development for various ophthalmic diseases. It is primarily funded by the DFG, the Federal Ministry of Education and Research (BMBF) and the EU plays an increasingly important role. Thus, ophthalmological research is integrated into numerous European research networks and beyond that into many international interconnections and relationships. In Germany, both clinical and basic research in ophthalmology is integrated into many international networks and is only functionally viable in an international context; however, given the increasing impact of ophthalmological research in Asian countries, future strategies require a continued focus on career development, research infrastructure, working environment and international cooperation.
Method: The available literature on neuro-ophthalmologic emergencies was reviewed, using available journals and internet based search engines and resources. Keywords employed were Neuro-ophthalmology Emergency and Ocular Morbidity. Result: The incidence of this group of emergencies is lower than that of other ...
de la Pena, Cristina Muniz; Friedlander, Myrna L.; Escudero, Valentin; Heatherington, Laurie
Sequential analyses examined associations between the working alliance and therapist-adolescent communication patterns in 10 Spanish cases of brief conjoint family therapy. Early sessions with strong versus problematic alliances, rated by observers, were selected for coding of relational control communication patterns. No differences were found in…
Lonigan, Christopher J.; Allan, Darcey M.; Phillips, Beth M.
There is strong evidence that self-regulatory processes are linked to early academic skills, both concurrently and longitudinally. The majority of extant longitudinal studies, however, have been conducted using autoregressive techniques that may not accurately model change across time. The purpose of this study was to examine the unique…
Mihai, Alina; Butera, Gretchen; Friesen, Amber
Research Findings: This qualitative study examined how Head Start teachers thought about children's early literacy and how they enacted their thinking in a year-long curriculum reform effort. Data collected included interviews, observations, questionnaires, concept maps, and teachers' reflections on implementation. The results indicated that as…
Ojanen, Tiina; Findley-Van Nostrand, Danielle; Bowker, Julie C.; Markovic, Andrea
This study examined the distinctiveness of and the correlates associated with anxious-withdrawal and unsociability during early adolescence in Finland (N = 384; 12-14 years; 53% girls). As expected, confirmatory factor analyses revealed that anxious-withdrawal and unsociability were distinct and moderately positively correlated constructs. Only…
Brown, Anthony L.
This article examines how African American scholars during the early twentieth century employed the genre of curriculum writing to challenge existing discourses of race. Drawing from the findings of a qualitative document analysis of textbooks created by Carter G. Woodson and Charles H. Wesley, this article illustrates how these authors used texts…
Molina, Danielle K.
Emergency response is an essential function of all residential life staff, but particularly for resident assistants serving on the front line. This organizational ethnography examined the role that professional identity played for early-career residential life practitioners engaged in emergency management. The data elucidated heroism as a…
This article examines three early career elementary teachers' orientations toward standards-based mathematics curriculum implementation in New York City public schools. It is important to have a greater understanding of teachers who are responsible for enacting standards-based curriculum in authentic teaching situations in order to learn more…
Batanova, Milena D.; Loukas, Alexandra
Guided by a social information processing perspective, this study examined the unique and interactive contributions of social anxiety and two distinct components of empathy, empathic concern and perspective taking, to subsequent relational and overt aggression in early adolescents. Participants were 485 10- to 14-year old middle school students…
Iachini, Aidyn L.; Rogelberg, Sandra; Terry, John David; Lutz, Amy
This article describes Aspire, a new motivational interviewing (MI) early intervention program designed to prevent dropout among students repeating the ninth grade, and then examines the feasibility and acceptability of this program through a mixed-methods approach. The Aspire program is a nine-lesson curriculum grounded in MI with an emphasis on…
Chan, Man Ching Esther
The Early Literacy Knowledge and Skills (ELKS) instrument was informed by the work of Ferreiro and Teberosky based on the notion that young children could be differentiated according to levels of sophistication in their understanding of the rules of written language. As an initial step to evaluate the instrument for teaching purposes, the present…
Bedel, Emine Ferda
This study aims to explore the locus of control, epistemological beliefs and metacognitive awareness levels of preservice early childhood education teachers and to determine the interrelations among these variables. 206 teacher candidates have been asked to fill out Rotter's Internal-External Locus of Control Scale, Central Epistemological Beliefs…
Early childhood education is a profession which requires the professional staff to spend considerable time in intense involvement with other people. The pressure from the demands this profession has can create a sense of physical and emotional exhaustion that often leads to burnout. Thus, previous research has linked perceptions of the work…
Bolduc, Jonathan; Evrard, Melanie
Children from birth to five are generally enthusiastic about music. However, because many early-childhood educators (ECEs) feel that they have insufficient knowledge to foster musical development, music education practices are not equivalent across ECEs. This study aimed to identify and determine the frequency of music activities used by ECEs. In…
Heberle, Amy E; Krill, Sarah C; Briggs-Gowan, Margaret J; Carter, Alice S
This study tested an ecological model predicting children's behavior problems in kindergarten from risk and protective factors (parent psychological distress, parenting behavior, and social support) during early childhood. Study participants were 1,161 sociodemographically diverse mother-child pairs that participated in a longitudinal birth cohort study. The predictor variables were collected at two separate time points and based on parent reports; children were an average of 2 years old at Time 1 and 3 years old at Time 2. The outcome measures were collected when children reached kindergarten and were 6 years old on average. Our results show that early maternal psychological distress, mediated by suboptimal parenting behavior, predicts children's externalizing and internalizing behaviors in kindergarten. Moreover, early social support buffers the relations between psychological distress and later suboptimal parenting behavior and between suboptimal parenting behavior and later depressive/withdrawn behavior. Our findings have several implications for early intervention and prevention efforts. Of note, informal social support appears to play an important protective role in the development of externalizing and internalizing behavior problems, weakening the link between psychological distress and less optimal parenting behavior and between suboptimal parenting behavior and children's withdrawal/depression symptoms. Increasing social support may be a productive goal for family and community-level intervention.
This study investigated the heterogeneity of depressive symptom trajectories and the roles of school-related factors in predicting the membership of different trajectories in a sample of early adolescents in Taiwan. In all, 870 junior high school students were followed for 3 years. Using growth mixture modeling, the study identified four distinct…
Shin, Huiyoung; Ryan, Allison M.
This study investigated early adolescent friendship selection and social influence with regard to academic motivation (self-efficacy and intrinsic value), engagement (effortful and disruptive behavior), and achievement (GPA calculated from report card grades) among 6th graders (N = 587, 50% girls at Wave 1; N = 576, 52% girls at Wave 2) followed…
Mikhail, David; Visscher, Kari L; Chen, Nancy; Wang, Joy; Emara, Barry Y; Hutnik, Cindy M
To evaluate the literacy level of patients with glaucoma in a tertiary care teaching centre compared with a rural community centre and to assess comprehension of and preference for educational material written at different reading levels. Prospective, randomized, double-blinded study. Patients with glaucoma presenting for routine examination or referral at a tertiary care academic centre in southwestern Ontario and a single general ophthalmology clinic located in a moderately sized suburban community in Ontario, Canada, were invited to participate in this study. Patients aged 19 to 90 with sufficient visual acuity to read the pamphlets were recruited. Eligible and consenting participants underwent a validated literacy study, and their literacy levels were classified as adequate, barely adequate, marginal, or inadequate. They were then randomized to receive educational pamphlets written at either a grade 5 (intervention group) or grade 10 (control group) reading level. Comprehension of and preference for the material were determined by analysis of cloze testing and a feedback questionnaire. Of 199 participants, 179 were included in the analysis. The literacy testing found that 35% of patients in the community practice and 30% in the tertiary care academic centre had "marginal" or "inadequate" literacy skills, but there was no significant difference between sites (p = 0.77). Comprehension of the educational material was higher in the intervention group versus the control group (p = 0.0057), with a mean cloze score of 57.9% in the intervention group and 48.3% in the control group. The intervention group spent significantly less time reading the pamphlets (p literacy skills. However, regardless of practice, all patients better comprehend, and were more receptive to, educational material written at grade 5 reading level with illustrations, regardless of initial literacy level. Copyright © 2015 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights
Full Text Available AIM: To analyze the characteristics of neurological ophthalmology manifestation of patients with neurosyphilis.METHODS: Retrospective and nonrandomized case analysis were used. Totally 22 cases of 39 eyes were included. They were 17 males and 5 females, aged from 34 to 65 years old. The average age were 49.6 years old. RESULTS: The optic nerve atrophy presented in 11 cases of 22 eyes. One eye of them accompanied by left eye oculomotor nerve palsy; 5 eyes in 3 cases expressed as optic neuritis acute phase; neuroretinitis appeared in 4 cases of 6 eyes; 1 case of 2 eyes expressed as chorioretinitis accompanied by optic disc edema; central retinal artery occlusion were found in 1 case of 1 eye. Argyll-Robertson pupil was as only manifestation in 2 cases of 3 eyes. In all cases, Argyll-Robertson pupil signs can be seen in 19 eyes. Treponema pallidum particle agglutination test(TPPAwere positive in all 22 cases. Syphilis rapid plasma reactin test(RPRwere positive in 19 of 21 cases. All patients underwent lumbar puncture and cerebrospinal fluid were detected for RPR, cerebrospinal fluid protein, white blood cell count. Cerebrospinal fluid RPR were positive in 13 cases. Cerebrospinal fluid protein were greater than 450mg/L in 18 cases. Cerebrospinal fluid white blood cell count were greater than 5/mm3 in 13 cases. CONCLUSION: Neurosyphilis involving neuro-ophthalmology often occurs in middle-aged men and subacute onset. Both eyes can suffered from optic nerve disease simultaneously or sequencely. A few can be expressed as other cranial nerve palsy, which may lead to misdiagnosis. Considering medical history, clinical manifestations, ophthalmic examination, serum and cerebrospinal fluid laboratory tests can improve the diagnostic rate.
Gordon, Lynn K
Paraneoplastic syndromes that affect the visual pathways and present with neuro-ophthalmologic signs or symptoms may involve the afferent or efferent systems. Afferent syndromes may involve the optic nerve or retina and, in some cases, these may be associated with systemic neurologic disease. Efferent symptoms typically affect eye movements and may involve the neuromuscular junction or involuntary eye movements. Literature review and personal clinical and research experience. Diagnosis of paraneoplastic syndromes relies on clinical and laboratory evaluations. In the appropriate clinical setting, the presence of specific antibodies may help confirm the diagnosis. In some cases, the visual pathway disturbance precedes a diagnosis of malignancy. Astute observation and selective evaluation and management are critical to establish the correct diagnosis and institute therapeutic approaches that can be sight or life saving.
Syrdalen, P. (Rikshospitalet, Oslo (Norway))
The article presents a brief history of the use of laser in ophthalmology in Norway, from the introduction of the first argon-photocoalulator in 1972 to the excimer laser in 1990. The argon-photocoagulator is in daily us in all Eye Departments in Norway and the main group of patients treated are those with diabetic retionopathy. Glaucoma has been treated with argon-laser with good results for the last ten years. YAG-laser, introduced in Norway in 1985, is used to treat secondary cataracts which occur after extracapsular cataract extractions and implantation of artificial lenses. In 1990, the excimer laser was introduced for refractive surgery (myopia, astigmatism). 4 refs., 6 figs., 1 tab.
Bille, J. F.
Ophthalmology has traditionally been the field with prevalent laser applications in medicine. The human eye is one of the most accessible human organs and its transparency for visible and near-infrared light allows optical techniques for diagnosis and treatment of almost any ocular structure. Laser vision correction (LVC) was introduced in the late 1980s. Today, the procedural ease, success rate, and lack of disturbing side-effects in laser assisted in-situ keratomileusis (LASIK) have made it the most frequently performed refractive surgical procedure (keratomileusis(greek): cornea-flap-cutting). Recently, it has been demonstrated that specific aspects of LVC can take advantage of unique light-matter interaction processes that occur with femtosecond laser pulses.
Pankov, O. P.
Extremely slow introduction of low-level laser therapy into the practice of ophthalmologists is restricted by the lack of good methodological recommendation and modern equipment adopted to the needs of ophthalmology. The most perspective is considered to be further improvement of the methods and the elaboration of the medical equipment, working in several wave bands, combined with magnetotherapy and working with the use of various modes of the modulation of the intensity of the luminous flux. It may be asserted that unlike the mode of continuous radiation, in some cases, the effectiveness of the treatment increases when the modulated light with the frequency of one to a few tens HZ is used. Moreover, the methods are being elaborated, when the modulation frequency of laser light and the biorhythms of man physiologic parameters are synchronized. Very perspective seems the computerization of the treatment process with the simultaneous electrophysiological control of the condition of visual functions.
Full Text Available Optical coherence tomography angiography(OCTAis a new technology of angiography in recent years. In addition to the advantages of traditional OCT, it can observe blood flow in different retinal and choroidal segmentation slab. By using the pseudo-color, abnormal vascular structure can be distinguished from normal vascular structure of the retina. Dye injection is not needed with OCTA, which is different from fundus fluorescein angiography(FFAand indocyanine green angiography(ICGA. OCTA provides more and more accurate blood flow information. However, like other biometric technology, OCTA has its limitations and shortcomings. This review will analyze and summarize the operating principle of OCTA, its application in ophthalmology, as well as its advantages and limitations.
Flynn, Megan; Rudolph, Karen D.
This study examined the proposal that difficulty understanding one's emotional experiences (i.e., deficits in emotional clarity) would interfere with the formulation of adaptive responses to interpersonal stress, which would then predict depressive symptoms. This process was examined across 3 years (fourth to sixth grade) during early…
Seema Dutt Bandhu
Full Text Available Introduction: E-learning is the use of internet for the purpose of education. E-learning in medical education is at a nascent stage in our country. The present study was carried out with the purpose of introducing e-learning to third year medical students in the subject of Ophthalmology and taking feedback on their attitude towards the new methodology of teaching and evaluating. Materials and Methods: E-learning was introduced to the seventh semester students of MBBS in the subject of Ophthalmology. The topics were converted to web friendly format and used for teaching and evaluating. Feedback was taken from the students on completion of the term on their attitudes towards e-learning and their views on the scope of e-learning in medical education. Results: All the students agreed on the usefulness of e-learning in medical education. Eleven students (27.5% found the medium of e-learning to be interesting, 15 (37.5% considered it to be easy and accessible, 10 (25% found it to be fast and easy, 4 (10% considered it to be a medium which can give updated information. Twenty-three (57.5% students considered that e-learning should be a medium of instruction in all the subjects, 15 (37.5% students considered its usefulness in clinical subjects only. Twenty-eight students (70% desired that e-learning should be used to provide important notes, questions, MCQs on all topics. Conclusions: E-learning is well accepted as a medium of instruction by medical students.
Cancer of the head and neck region presents a challenge since, unlike other areas of the body, the boundaries are not always easy to delineate. The functional morbidity associated with head and neck cancer and its treatment are considerable. Head and neck cancer is described as cancer of the lip, mouth, tongue, tonsil, pharynx (unspecified), salivary gland, hypopharynx, larynx and other. Oral cancer refers to cancers of the lip, tongue, gingivae, floor of the mouth, palate (hard and soft), maxilla, vestibule and retromolar area up to the anterior pillar of the fauces (tonsil). When patients present with oral cancer, over 60% of them have regional (lymph node) and sometimes distant (metastatic) spread. The overall five-year survival rates for oral cancer average at between 50 and 80%, depending on the stage of the disease, varying from 86% for stage I to 12-16% for stage IV. The incidence of \\'field cancerisation\\'\\/unstable oral epithelium is high (17%), and even after successful treatment our patients need to be monitored for dental care and further disease. Unlike other areas in the body, the oral epithelium is readily accessible for examination and even self-examination. Dentists and dental hygienists are effective clinicians in the examination of the oral cavity for mouth cancer. An oral and neck examination must be part of every dental examination. An examination protocol is suggested here, which is similar to, but more detailed than, the standardised oral examination method recommended by the World Health Organisation, and consistent with those protocols followed by the Centres for Disease Control and Prevention and the National Institutes of Health.
MacCarthy, Denise; Flint, Stephen R; Healy, Claire; Stassen, Leo F A
Cancer of the head and neck region presents a challenge since, unlike other areas of the body, the boundaries are not always easy to delineate. The functional morbidity associated with head and neck cancer and its treatment are considerable. Head and neck cancer is described as cancer of the lip, mouth, tongue, tonsil, pharynx (unspecified), salivary gland, hypopharynx, larynx and other. Oral cancer refers to cancers of the lip, tongue, gingivae, floor of the mouth, palate (hard and soft), maxilla, vestibule and retromolar area up to the anterior pillar of the fauces (tonsil). When patients present with oral cancer, over 60% of them have regional (lymph node) and sometimes distant (metastatic) spread. The overall five-year survival rates for oral cancer average at between 50 and 80%, depending on the stage of the disease, varying from 86% for stage I to 12-16% for stage IV. The incidence of 'field cancerisation'/unstable oral epithelium is high (17%), and even after successful treatment our patients need to be monitored for dental care and further disease. Unlike other areas in the body, the oral epithelium is readily accessible for examination and even self-examination. Dentists and dental hygienists are effective clinicians in the examination of the oral cavity for mouth cancer. An oral and neck examination must be part of every dental examination. An examination protocol is suggested here, which is similar to, but more detailed than, the standardised oral examination method recommended by the World Health Organisation, and consistent with those protocols followed by the Centres for Disease Control and Prevention and the National Institutes of Health.
Widom, Cathy Spatz; Schuck, Amie M; White, Helene Raskin
Using prospective data from a cohort design study involving documented cases of child abuse and neglect and a matched control group, we examine two potential pathways between childhood victimization and violent criminal behavior: early aggressive behavior and problematic drinking. Structural equation models, including controls for race/ethnicity, socioeconomic status, parental alcoholism, and parental criminality, revealed different pathways for men and women. For men, child maltreatment has direct and indirect (through aggressive behavior and problematic alcohol use) paths to violence. For women, problematic alcohol use mediates the relationship between childhood victimization and violence, and, independent of child maltreatment, early aggression leads to alcohol problems, which lead to violence. Interventions for victims of childhood maltreatment need to recognize the role of early aggressive behavior and alcohol problems as risk factors for subsequent violence.
Howell, J B
Preventing death from malignant melanoma is the most pressing issue in preventive dermatology in the United States because the mortality rate has increased markedly. Dermatologists, as the physicians best suited by training to identify early malignant melanoma, need to take the lead in developing a national project of educating physicians, patients, and the public to recognize the clinical features of early malignant melanoma and to appreciate that prompt excision results in a high rate of cure. The immediate challenge is to commit ourselves to examining every new patient and to conducting periodic "skin scans" of every patient at increased risk for melanoma. Just as the Papanicolaou screening test has markedly reduced cervical cancer mortality rates, commitment to early identification and excision of melanomas can mean a comparable triumph for preventive dermatology and will help us meet the challenge of our Australian colleagues to make melanoma a word, not a death sentence.
Maria Cecília Remígio
Full Text Available OBJETIVO: Relatar os achados oftalmológicos em portadores de múltiplas deficiências. MÉTODOS: Foram estudados 274 usuários do Sistema Único de Saúde atendidos no Departamento de Oftalmologia Pediátrica e Estrabismo da Fundação Altino Ventura (FAV, no período de junho a setembro de 2004. RESULTADOS: A freqüência dos pacientes quanto ao gênero foi de 58,5% para o masculino e 41,5% para o feminino. A variação das idades foi de 0,1 a 20 anos com mediana de 5. A maioria (61,3% dos pacientes apresentava boa acuidade visual, contudo 38,7% apresentava baixa de visão (PURPOSE: To report the visual findings in patients with multiple handicaps. METHODS: Two hundred and seventy-four patients cared for at the Pediatric and Strabismus Ophthalmology Department of the "Fundação Altino Ventura" - Brazilian National Health System, were examined from June to September 2004. Age varied from 0.1 to 20 years with a median of 5. RESULTS: The majority of the patients (61.3% presented good visual acuity; however low visual acuity (< 20/80 was observed in 38.7% of the patients. Heterotropias were observed in 66 patients (24.0%; astigmatism (53.2% and hyperopia (29.0% were more frequent. CONCLUSION: Children with multiple handicaps need an early ophthalmologic diagnosis and treatment for better global development. The integration of a multidisciplinary team with pediatricians, pediatric ophthalmologists and specialists in low vision, may assure a better visual rehabilitation.
Kalantzis, G; Georgalas, I; Tsiamis, C; El-Hindy, N; Poulakou-Rebelakou, E
Gonioscopy is a technique used to examine structures in the anterior chamber angle (the fluid filled space inside the eye between the iris and the innermost layer of the cornea, the endothelium). It is an essential tool in ophthalmic practice, particularly in the diagnosis of glaucoma. In 1899, the Greek ophthalmologist Alexios Trantas was the first to visualise the angle in vivo and coined the term 'gonioscopy'. He made a number of other important contributions to ophthalmology.
Stanzel, B V; Meyer, C H
Smartphones offer a number of so-called medical and ophthalmic "apps" and their use will be investigated in this survey. An Internet analysis was performed to identify available medical "apps" and evaluate their utilization. Search engines, developers' websites and webstores were screened with key words such as: "smartphone", "medical apps" and "eye test". The "apps" were evaluated for usability and with respective published reviews. In addition, an international survey among ophthalmologists asked about the use of a Smartphone and "apps" preferences. Direct inquiries were undertaken with developers on selected promising novel "apps". The more than 70 identified "apps" examined were subdivided into different categories A) examining function, B) photo and video recordings, C) office, D) patient education and informed consent as well as E) medical continued education functions and literature searching. The survey determined the iPhone to be the most popular Smartphone among the sampled ophthalmologists worldwide. Many popular "apps" have become available only recently and hence suffer in part from some initial technical problems. Some ophthalmic "apps" are very helpful in the emergency room or during consultations. Only a few "apps" were approved as medical products and therefore cannot substitute a full ophthalmic examination. The increasing distribution of Smartphone "apps" in ophthalmology may have the potential to facilitate patient treatment, data management and communication.
Froh, Jeffrey J.; Yurkewicz, Charles; Kashdan, Todd B.
Gratitude was examined among 154 students to identify benefits from its experience and expression. Students completed measures of subjective well-being, social support, prosocial behavior, and physical symptoms. Positive associations were found between gratitude and positive affect, global and domain specific life satisfaction, optimism, social…
Moran, Christine E.; Senseny, Karlen
American students typically attend kindergarten at the chronological age (CA) of five and currently with the implementation of Common Core State Standards, there are expectations that children learn how to read in order to meet these academic standards, despite whether or not they are developmentally ready. This mixed methods study examined age…
Rodgers, Emily; D'Agostino, Jerome V.; Harmey, Sinéad J.; Kelly, Robert H.; Brownfield, Katherine
In this study, we used Reading Recovery as the context to examine the relationship between three types of contingent teaching (temporal, instructional, and domain contingency) and student outcomes in a one-to-one literacy tutoring setting. We first created a National Teacher Effectiveness Index for all Reading Recovery teachers in the country and…
Wei, Hsi-Sheng; Jonson-Reid, Melissa
Friendship is typically assumed to be a protective factor for victims of school bullying, so the possibility of victimization by friends is rarely explored. This study examines the prevalence of positive affiliation between the victims and aggressors in verbal and physical bullying. Peer nomination inventories were used to assess the friendship…
This qualitative study guided by portraiture (Lawrence-Lightfoot & Davis, 1997) explores the affective side of mathematics teaching which has often been ignored as mathematics research has focused more on cognition. Grounded in social constructivism (Ernest, 1988) and reflective practice (Dewey, 1933; Schon, 1983), this research examines three…
Cetin, Ozlem Simsek; Bay, Neslihan
The purpose of this study is to examine the uses of print features in preschool children's books in the US and Turkey, in order to helping adults to understand print features and supporting children's print awareness. In this context, two hundred children's books was randomly selected from the US and Turkey. Document analysis was used for…
Regalla, Michele; Peker, Hilal
This preliminary study examined a prekindergarten multimodal French program conducted for students in an inclusion charter school. Due to the age and varied ability levels of the students, media such as video and songs combined with kinesthetic activities served as the primary instructional approach. Data on children's ability to understand and…
Nevo, Ori; Brown, Richard; Glanc, Phyllis; Lim, Ken
This guideline presents an evidence-based technical update and recommendations for the performance of early comprehensive fetal anatomic scanning (ECFAS) at 11 to 16 weeks' gestation. Patients at high risk for fetal anomalies and in whom traditional mid-second trimester transabdominal imaging may be challenging or who may benefit from earlier identification of fetal anomalies may be suitable for early fetal anatomy scanning. This practice may result in earlier identification of fetal anomalies and provide earlier intervention options in high-risk populations and/or in populations where mid-second trimester transabdominal scanning is challenging. This population consists of obstetrical patients in whom mid-second trimester ultrasound scanning will be technically challenging and patients who are at higher risk for major fetal anomalies. Published literature was retrieved through searches of PubMed and Medline in 2016 using key words. Results were restricted to controlled clinical trials, reviews, and observational studies published in English. There were no date restrictions, and searches were updated in the guideline to 2016. Grey (unpublished) literature was identified through searching the websites of health technology assessment and clinical practice guidelines and national and international medical specialty societies. No relevant studies were found. The content and recommendations were drafted and agreed on by the principal authors. The Board of the SOGC approved the final draft for publication. The quality of evidence was rated using the criteria described in the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology framework. It is anticipated that there will be an increase in earlier detection of major fetal anomalies in the target population with the benefits of earlier interventions for those individuals. In areas where the service is not available the patient may need to travel to a nearby centre. Early fetal anatomy
The aim of this study was examination of academic achievement of early adolescents with visual impairments. Eighty eight children from Turkey, (age = 12.30 ± 1.22 years; height = 144.10 ± 5.51 cm; weight = 41.45 ± 4.68 kg) for twenty female athletes, (age = 12.30 ± 1.79; height = 151.04 ± 7.49 cm; weight = 48.18 ± 7.63 kg) for twenty seven male…
Ji, Z K; Zhao, Y; Yu, S S; Zhao, H
3D printing is a kind of technology that makes 3D models from computer-aided designs through additive manufacturing, in which successive layers of the material are deposited onto underlying layers to construct 3D objects. In recent years, 3D printing is gradually applied in the field of ophthalmology, such as the cornea, retina, orbital operation, ocular tumor radiotherapy, ocular implants and ophthalmology teaching. This article reviews the application status of 3D printing technology in the basic research and clinical treatment in ophthalmology. (Chin J Ophthalmol, 2018, 54: 72-76) .
Yara Dadalti Fragoso
Full Text Available Interferons alpha and beta have been used worldwide for a few decades, altering the natural history of several severe diseases including hepatitis C, cancer and immune-mediated conditions such as multiple sclerosis. The adverse events profile of interferons is well established, but only isolated reports of ophthalmological complications of interferon therapy have been published. The objective of this study was to carry out a literature systematic review on the subject, bringing to light the need for careful ophthalmological monitoring of patients undergoing interferon treatment. Nearly 500 cases of ophthalmological complications related to interferon have been reported. The most frequent findings were soft exudates, hemorrhages and retina ischemia.
Chen, Haoyu; Chen, Chun Hui; Jhanji, Vishal
Publication speed of peer-reviewed journals may play a major role in early dissemination of knowledge and may raise the citation index. In this study, we evaluated the publication speed of ophthalmology journals. Observational study. Observational study of bibliometric data in published ophthalmology journals. A list of ophthalmic journals featured in the 2010 Journal Citation Report was obtained on September 1, 2011. A total of 12 articles were chosen randomly from each of these journals published between January and December 2010. Median publication time and interquartile range (IQR) were obtained from the full texts of the published articles. Time lag between submission and revision, acceptance, and publication of the manuscripts was calculated. Correlation between publication time lag and journal impact factor as well as advance online publication was analyzed. A total of 51 ophthalmic journals were included. There was no statistically significant difference in the impact factors of journals based on their reporting of submission, revision, or acceptance times of the manuscripts (both P>0.05, Wilcoxon test). The median peer review and publication time of all ophthalmology journals was 133 days (IQR, 100.5-171.5) and 100 days (IQR, 62.9-166.3), respectively. There was no correlation between the journal impact factors and publication time lag (Spearman correlation). Approximately half of the ophthalmology journals (n = 26; 50.98%) published online in advance. Journals with advance online publication had higher impact factors compared with those without this feature (median, 1.692 [IQR, 1.05-2.80] vs. 1.02 [0.39-1.53]; P = 0.015, Mann-Whitney U test). For journals with advance online publication, the median time from acceptance to advance online publication (74.3 days [IQR, 48.3-115 days]) was significantly shorter than the median time between acceptance and print publication (170.75 days [IQR, 101.4-217 days]; Pimpact factors. Advance online publication facility
Chan, Toby YB; Rai, Amandeep S; Lee, Edwin; Glicksman, Jordan T; Hutnik, Cindy ML
Background: This cross-sectional survey assessed the adequacy of ophthalmology teaching in undergraduate medical education and evaluated the comfort level of family medicine residents in diagnosing and managing common ophthalmic conditions. Methods: Postgraduate year 1 and 2 family medicine residents at the University of Western Ontario were recruited for this study. The main outcome measures were hours of classroom and clinic-based instruction on ophthalmology during undergraduate medical education, and the comfort level in ophthalmic clinical skills and managing various ophthalmic conditions. Results: In total, 54 (33.3%) of 162 family medicine residents responded to the survey. Residents reported an average of 27.1 ± 35.1 hours and 39.8 ± 47.1 hours of classroom and clinical ophthalmology instruction, respectively. However, most residents (80%) responded as feeling only “somewhat comfortable” or “not at all comfortable” in assessing and managing common ophthalmic conditions, including ocular emergencies, such as acute angle closure glaucoma and ocular chemical burn. A positive correlation was seen between overall comfort level and hours of classroom instruction (P ophthalmology training received by family medicine residents during medical school meets the International Council of Ophthalmology Task Force recommendations. However, family medicine residents appear to be uncomfortable in handling treatable but potentially sight-threatening ocular conditions. Standardizing the undergraduate medical education ophthalmology curriculum and increasing hours of ophthalmology training during postgraduate family medicine residency may be useful in bridging this gap in knowledge. PMID:21468339
Christine E. Moran; Karlen Senseny
American students typically attend kindergarten at the chronological age (CA) of five and currently with the implementation of Common Core State Standards, there are expectations that children learn how to read in order to meet these academic standards, despite whether or not they are developmentally ready. This mixed methods study examined age and environmental factors that relate to reading with 83 children from the ages of 4–6½ years. The relationship between developmental age (DA) via the...
Chan, Noel C Y; Chan, Carmen K M
In the last decade, with the advances of optical coherence tomography (OCT) technology, different imaging protocols and analysis algorithms have been introduced to maximize the potential of this diagnostic tool in the evaluation of different eye diseases. This review aims to provide an update on these additional features, with respect to the management of a diverse range of neuro-ophthalmologic conditions. Macular ganglion cell complex (mGCC) analysis has been shown to be superior to peripapillary retinal nerve fiber layer (pRNFL) analysis in certain settings, such as differentiating Leber's hereditary optic neuropathy from functional visual loss; monitoring neurodegenerative diseases or multiple sclerosis; and predicting visual loss in nonarteritic ischemic optic neuropathy. mGCC analysis also demonstrates high correlation with perimetry and might serve as an early structural indicator of irreversible neuronal loss. Compared to pRNFL, retinal thickness analysis of the optic nerve head demonstrates better correlation with the severity of papilledema, thus enabling its possible application in detecting raised intracranial pressure, especially in the pediatric group. Upcoming research on emerging OCT technologies including OCT-angiography, enhanced depth imaging, retinal single-layer analysis and portable systems will hopefully further enhance the utility of OCT in the field. It is crucial for neuro-ophthalmologists to be updated and familiar with these newer OCT imaging protocols and to make appropriate choices for different clinical scenarios, in order to optimize the diagnostic sensitivity and specificity.
Marfe, Gabriella; Massaro-Giordano, Mina; Ranalli, Marco; Cozzoli, Eliana; Di Stefano, Carla; Malafoglia, Valentina; Polettini, Marco; Gambacurta, Alessandra
Stem cell technology has evoked considerable excitement among people interested in the welfare of animals, as it has suggested the potential availability of new tools for several pathologies, including eye disease, which in many cases is considered incurable. One such example is ulcerative keratitis, which is very frequent in horses. Because some of these corneal ulcers can be very severe, progress rapidly and, therefore, can be a possible cause of vision loss, it is important to diagnose them at an early stage and administer an appropriate treatment, which can be medical, surgical, or a combination of both. The therapeutic strategy should eradicate the infection in order to reduce or stop destruction of the cornea. In addition, it should support the corneal structures and control the uveal reaction, and the pain associated with it, in order to minimize scarring. In this study, we address how stem cells derived from peripheral blood can be used also in ophthalmological pathologies. Our results demonstrate that this treatment protocol improved eye disease in four horse cases, including corneal ulcers and one case of retinal detachment. In all cases, we detected a decrease in the intense inflammatory reaction as well as the restoration of the epithelial surface of the central cornea. Copyright © 2011 Wiley Periodicals, Inc.
Lukowski, Angela F; Milojevich, Helen M
The ability to recall the past allows us to report on details of previous experiences, from the everyday to the significant. Because recall memory is commonly assessed using verbal report paradigms in adults, studying the development of this ability in preverbal infants and children proved challenging. Over the past 30 years, researchers have developed a non-verbal means of assessing recall memory known as the elicited or deferred imitation paradigm. In one variant of the procedure, participants are presented with novel three-dimensional stimuli for a brief baseline period before a researcher demonstrates a series of actions that culminate in an end- or goal-state. The participant is allowed to imitate the demonstrated actions immediately, after a delay, or both. Recall performance is then compared to baseline or to performance on novel control sequences presented at the same session; memory can be assessed for the individual target actions and the order in which they were completed. This procedure is an accepted analogue to the verbal report techniques used with adults, and it has served to establish a solid foundation of the nature of recall memory in infancy and early childhood. In addition, the elicited or deferred imitation procedure has been modified and adapted to answer questions relevant to other aspects of cognitive functioning. The broad utility and application of imitation paradigms is discussed, along with limitations of the approach and directions for future research.
Full Text Available Botulinum neurotoxin (BoNT is the first biological toxin used in the treatment of ophthalmic diseases and to decrease skin wrinkles as an aesthetic agent. When used appropriately, it weakens the force of muscular contraction and/or inhibits glandular secretion. The most common areas for botulinum toxin treatment are the upper face, including the glabella, forehead, brows, and lateral canthal lines or crow’s feet. By relaxing the muscles causing wrinkles, non-permanent results may be achieved with its use. BoNT has gained widespread use in a variety of ophthalmic diseases. The effect of BoNT is temporary, but the therapeutic benefit is usually maintained even after repeated injections. Treatment is usually well tolerated. Complications and side effects associated with the treatment are rare and temporary. Complications occur due to weakness (chemodenervation of adjacent muscle groups, immunological mechanisms and injection technique. Current therapeutic indications, doses, complications and contraindications of BoNT use in the following disorders related to ophthalmology were investigated: aesthetic use, strabismus, blepharospasm, hemifacial spasm, eyelid retraction, entropion, lacrimal hypersecretion syndrome, and facial paralysis.
Başar, Emel; Arıcı, Ceyhun
Botulinum neurotoxin (BoNT) is the first biological toxin used in the treatment of ophthalmic diseases and to decrease skin wrinkles as an aesthetic agent. When used appropriately, it weakens the force of muscular contraction and/or inhibits glandular secretion. The most common areas for botulinum toxin treatment are the upper face, including the glabella, forehead, brows, and lateral canthal lines, or crow’s feet. By relaxing the muscles causing wrinkles, non-permanent results may be achieved with its use. BoNT has gained widespread use in a variety of ophthalmic diseases. The effect of BoNT is temporary, but the therapeutic benefit is usually maintained even after repeated injections. Treatment is usually well tolerated. Complications and side effects associated with the treatment are rare and temporary. Complications occur due to weakness (chemodenervation) of adjacent muscle groups, immunological mechanisms and injection technique. Current therapeutic indications, doses, complications and contraindications of BoNT use in the following disorders related to ophthalmology were investigated: aesthetic use, strabismus, blepharospasm, hemifacial spasm, eyelid retraction, entropion, lacrimal hypersecretion syndrome, and facial paralysis. PMID:28050326
Rosenwasser, George O. D.
Echography has become a valuable diagnostic tool in ophthalmology. Ultrasonic biomicroscopy (UBM) in particular may be applied to the evaluation of small lesions of the anterior segment of the eye. Disease processes such as conjunctival and iris melanoma, other forms of neoplasia, intraocular cysts, narrow angle glaucoma, and intraocular foreign bodies can be diagnostically evaluated and followed longitudinally by UBM. Combining UBM with spectroscopy may become useful in determining cell type origins of a variety of tumors. Eye banking also has an increased need for UBM in corneal tissue banking. The recent development of the Laser In Situ Keratomileusis procedure has allowed corneal surgeries to create a partial thickness flap of tissue in the cornea, remove tissue from the base of the cornea with excimer laser ablation, and replace the hinged flap. This causes a substantial change in refractive error while thinning the cornea and leaving an interface within the corneal stroma. The ability to detect this type of surgery is essential in eye banking. Ultrasonic pachymetry to determine central thickness and biomicroscopy to detect the presence of an interface are essential in avoiding the use of these corneas for transplantation purposes. Determining the topography of the preserved corneas is another potential application for ultrasonography. Using this information to reduce optical aberration after transplant is crucial in improving visual performance post transplantation. A review of the anatomy of the eye, pathology of ocular diseases relevant to UBM, and principles of eye banking will be presented.
This short paper mentioned the medical treatment using the 'holy' springs, the first 'eye doctor' in Denmark, the first picture of spectacles which was found in Viborg Cathedral of the high priest before he performs circumcisio praeputii on Jesus Christ, further cataract reclination in Denmark from around year zero and cataract extraction in 1667 in Denmark on a goose by Francisco Borri and on humans by the Danish Georg Heuermann in 1755. Epidemic military eye diseases in 1807, 1856 and 1865 are also described in this study. From 1856, a new ophthalmological period started in Denmark with the first eye hospital (lazaret only for eye diseases), and in 1864, patients with eye diseases were transported from the few beds in the surgical departments in the municipal hospital to the first civil eye department in Denmark, the eye hospital Sct. Annae in Copenhagen. The new scientific period started with Jacob Christian Bentz (ophthalmia granulosa, joint editor of the Danish Medical Journal) and Heinrich Lehmann. © 2016 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.
Mohammadpour, Mehrdad; Heidari, Zahra; Mirghorbani, Masoud; Hashemi, Hassan
Telemedicine is an emerging field in recent medical achievements with rapid development. The "smartphone" availability has increased in both developed and developing countries even among people in rural and remotes areas. Tele-based services can be used for screening ophthalmic diseases and also monitoring patients with known diseases. Electronic ophthalmologic records of the patients including captured images by smartphones from anterior and posterior segments of the eye will be evaluated by ophthalmologists, and if patients require further evaluations, they will be referred to experts in the relevant field. Eye diseases such as cataract, glaucoma, age-related macular degeneration, diabetic retinopathy, and retinopathy of prematurity are the most common causes of blindness in many countries and beneficial use of teleophthalmology with smartphones will be a good way to achieve the aim of VISION 2020 all over the world. Numerous studies have shown that teleophthalmology is similar to the conventional eye care system in clinical outcomes and even provides more patient satisfaction as it saves time and cost. This review explains how teleophthalmology helps to improve patient outcomes through smartphones.
Chwalisz, Bart K; Bouffard, Marc A; Prasad, Sashank; Cestari, Dean M
We review new applications of optical coherence tomography (OCT) technology in neuro-ophthalmology. We also describe new technologies for visualizing the extracranial vessels in the diagnosis of giant cell arteritis (GCA). Newer OCT modalities are expanding the evaluation of the optic disc, and are being applied to a number of neurologic conditions such as demyelinating and neurodegenerative disease. Swept-source OCT and enhanced-depth imaging OCT are refining the fine-grained analysis of the optic nerve head in the diagnosis of papilledema and optic nerve drusen. OCT-angiography is opening up new avenues to the study of the vasculature of the optic nerve head and its disorders, including ischemic optic neuropathy. Newer technologies in the diagnosis of GCA include vascular ultrasound, magnetic resonance imaging (MRI) of the extracranial vasculature and PET imaging of the large vessels. OCT and several of its derivations are advancing diagnosis, and in some cases prognostication, in a variety of inflammatory, ischemic and compressive optic neuropathies. These technologies hold potential in the laboratory as well, yielding insights into the mechanisms of a variety of neurological conditions. In addition, further developments in MRI and ultrasonography techniques are shaping the approach to the diagnosis of GCA.
Cabral, Thiago; DiCarlo, James E; Justus, Sally; Sengillo, Jesse D; Xu, Yu; Tsang, Stephen H
The present review seeks to summarize and discuss the application of clustered regularly interspaced short palindromic repeats (CRISPR)-associated systems (Cas) for genome editing, also called genome surgery, in the field of ophthalmology. Precision medicine is an emerging approach for disease treatment and prevention that takes into account the variability of an individual's genetic sequence. Various groups have used CRISPR-Cas genome editing to make significant progress in mammalian preclinical models of eye disease, the basic science of eye development in zebrafish, the in vivo modification of ocular tissue, and the correction of stem cells with therapeutic applications. In addition, investigators have creatively used the targeted mutagenic potential of CRISPR-Cas systems to target pathogenic alleles in vitro. Over the past year, CRISPR-Cas genome editing has been used to correct pathogenic mutations in vivo and in transplantable stem cells. Although off-target mutagenesis remains a concern, improvement in CRISPR-Cas technology and careful screening for undesired mutations will likely lead to clinical eye therapeutics employing CRISPR-Cas systems in the near future.
Full Text Available Telemedicine is an emerging field in recent medical achievements with rapid development. The “smartphone” availability has increased in both developed and developing countries even among people in rural and remotes areas. Tele-based services can be used for screening ophthalmic diseases and also monitoring patients with known diseases. Electronic ophthalmologic records of the patients including captured images by smartphones from anterior and posterior segments of the eye will be evaluated by ophthalmologists, and if patients require further evaluations, they will be referred to experts in the relevant field. Eye diseases such as cataract, glaucoma, age-related macular degeneration, diabetic retinopathy, and retinopathy of prematurity are the most common causes of blindness in many countries and beneficial use of teleophthalmology with smartphones will be a good way to achieve the aim of VISION 2020 all over the world. Numerous studies have shown that teleophthalmology is similar to the conventional eye care system in clinical outcomes and even provides more patient satisfaction as it saves time and cost. This review explains how teleophthalmology helps to improve patient outcomes through smartphones.
Marchili, Nicola; Ortu, Eleonora; Pietropaoli, Davide; Cattaneo, Ruggero; Monaco, Annalisa
Stomatognathic system is strictly correlated to other anatomical regions; many studies investigated relationship between temporomandibular joint and posture, several articles describe cranio-facial pain from dental causes, such as trigger points. Until now less interest has been given to connections between dental occlusion and ophthalmology, even if they are important and involving. Clinical experience in dental practice claims that mandibular latero-deviation is connected both to eye dominance and to defects of ocular convergence. The trigeminal nerve is the largest and most complex of the twelve cranial nerves. The trigeminal system represents the connection between somitic structures and those derived from the branchial arches, collecting the proprioception from both somitic structures and oculomotor muscles. The intermedius nucleus of the medulla is a small perihypoglossal brainstem nucleus, which acts to integrate information from the head and neck and relays it on to the nucleus of the solitary tract where autonomic responses are generated. This intriguing neurophysiological web led our research group to investigate anatomical and functional associations between dental occlusion and vision. In conclusion, nervous system and functional pathways strictly connect vision and dental occlusion, and in the future both dentists and oculists should be more and more aware of this correlation for a better diagnosis and therapy.
Beavers, Angela J; Stagner, Anna M; Allbery, Sandra M; Lyden, Elizabeth R; Hejkal, Thomas W; Haney, Suzanne B
Dilated fundoscopic exam is considered the gold standard for detecting retinal hemorrhage, but expertise in obtaining this exam is not always immediately available. MRI can detect retinal hemorrhages, but correlation of the grade or severity of retinal hemorrhage on dilated fundoscopic exam with retinal hemorrhage visibility on MRI has not been described. To determine the value of standard brain protocol MRI in detecting retinal hemorrhage and to determine whether there is any correlation with MR detection of retinal hemorrhage and the dilated fundoscopic exam grade of hemorrhage. We conducted a retrospective chart review of 77 children exam or retinal camera images. A staff pediatric radiologist and radiology resident reviewed the MR images. Retinal hemorrhages were graded by a chief ophthalmology resident on a 12-point scale based on the retinal hemorrhage type, size, location and extent as seen on review of retinal camera images and detailed reports by ophthalmologists. Higher scores indicated increased severity of retinal hemorrhages. There was a statistically significant difference in the median grade of retinal hemorrhage examination between children who had retinal hemorrhage detected on MRI and children who did not have retinal hemorrhage detected on MRI (P = 0.02). When examination grade was categorized as low-grade (1-4), moderate-grade (5-8) or high-grade (>8) hemorrhage, there was a statistically significant association between exam grade and diagnosis based on MRI (P = 0.008). For example, only 14% of children with low-grade retinal hemorrhages were identified on MRI compared to 76% of children with high-grade hemorrhages. MR detection of retinal hemorrhage demonstrated a sensitivity of 61%, specificity of 100%, positive predictive value of 100% and negative predictive value of 63%. Retinal hemorrhage was best seen on the gradient recalled echo (GRE) sequences. MRI using routine brain protocol demonstrated 61% sensitivity and 100% specificity
Beavers, Angela J.; Allbery, Sandra M. [University of Nebraska Medical Center, Department of Radiology, Omaha, NE (United States); Children' s Hospital and Medical Center, Department of Radiology, Omaha, NE (United States); Stagner, Anna M.; Hejkal, Thomas W. [University of Nebraska Medical Center, Department of Ophthalmology, Omaha, NE (United States); Children' s Hospital and Medical Center, Department of Ophthalmology, Omaha, NE (United States); Lyden, Elizabeth R. [University of Nebraska Medical Center, College of Public Health, Omaha, NE (United States); Haney, Suzanne B. [Children' s Hospital and Medical Center, Department of Pediatrics, Omaha, NE (United States); University of Nebraska Medical Center, Department of Pediatrics, Omaha, NE (United States)
Dilated fundoscopic exam is considered the gold standard for detecting retinal hemorrhage, but expertise in obtaining this exam is not always immediately available. MRI can detect retinal hemorrhages, but correlation of the grade or severity of retinal hemorrhage on dilated fundoscopic exam with retinal hemorrhage visibility on MRI has not been described. To determine the value of standard brain protocol MRI in detecting retinal hemorrhage and to determine whether there is any correlation with MR detection of retinal hemorrhage and the dilated fundoscopic exam grade of hemorrhage. We conducted a retrospective chart review of 77 children <2 years old who were seen for head trauma from April 2007 to July 2013 and had both brain MRI and dilated fundoscopic exam or retinal camera images. A staff pediatric radiologist and radiology resident reviewed the MR images. Retinal hemorrhages were graded by a chief ophthalmology resident on a 12-point scale based on the retinal hemorrhage type, size, location and extent as seen on review of retinal camera images and detailed reports by ophthalmologists. Higher scores indicated increased severity of retinal hemorrhages. There was a statistically significant difference in the median grade of retinal hemorrhage examination between children who had retinal hemorrhage detected on MRI and children who did not have retinal hemorrhage detected on MRI (P = 0.02). When examination grade was categorized as low-grade (1-4), moderate-grade (5-8) or high-grade (>8) hemorrhage, there was a statistically significant association between exam grade and diagnosis based on MRI (P = 0.008). For example, only 14% of children with low-grade retinal hemorrhages were identified on MRI compared to 76% of children with high-grade hemorrhages. MR detection of retinal hemorrhage demonstrated a sensitivity of 61%, specificity of 100%, positive predictive value of 100% and negative predictive value of 63%. Retinal hemorrhage was best seen on the gradient
Lee, Seon-Young; Sagoo, Harkiran; Farwana, Reem; Whitehurst, Katharine; Fowler, Alex; Agha, Riaz
Systematic reviews and meta-analyses are becoming increasingly important methods to summarize published research. Studies of ophthalmology may present additional challenges because of their potentially complex study designs. The aim of this study was to evaluate the reporting quality of systematic reviews and meta-analyses on topics in ophthalmology to determine compliance with the PRISMA guidelines. We assessed articles published between 2010 and 2015 in the five major relevant journals with the highest impact factors. The MEDLINE and EMBASE databases were searched to identify systematic reviews published between January 2010 and December 2015 in the following 5 major ophthalmology journals: Progress in Retinal and Eye Research, Ophthalmology, Archives of Ophthalmology, American Journal of Ophthalmology, and Survey of Ophthalmology. The screening, identification, and scoring of articles were independently performed by two teams, and the results were submitted to statistical analysis to determine medians, ranges, and 95% CIs. A total of 115 articles were included. The median compliance was 15 out of 27 items (56%), the range was 5-26 (26-96%), and the inter-quartile range was 10 (37%). Compliance was highest in items related to the 'description of rationale' (item 3, 100%) and sequentially lower in 'the general interpretation of results' (item 26, 96%) and 'the inclusion of a structured summary in the abstract' (item 2, 90%). Compliance was poorest in the items 'indication of review protocol and registration' (item 5, 9%), 'specification of risk of biases that may affect the cumulative evidence' (item 15, 24%), and 'description of clear objectives in the introduction' (item 4, 26%). The reporting quality of systematic reviews and meta-analyses in ophthalmology should be significantly improved. While we recommend the use of the PRISMA criteria as a guideline before journal submission, additional research aimed at identifying potential barriers to compliance may be
Lira, Rodrigo Pessoa Cavalcanti; Leal, Franz Schubert; Gonçalves, Fauze Abdulmassih; Amorim, Fernando Henrique Ramos; Felix, João Paulo Fernandes; Arieta, Carlos Eduardo Leite
To compare clinical trials published in Brazilian journals of ophthalmology and in foreign journals of ophthalmology with respect to the number of citations and the quality of reporting [by applying the Consolidated Standards for Reporting Trials (CONSORT) statement writing standards]. The sample of this systematic review comprised the two Brazilian journals of ophthalmology indexed at Science Citation Index Expanded and six of the foreign journals of ophthalmology with highest Impact Factor® according ISI. All clinical trials (CTs) published from January 2009 to December 2010 at the Brazilians journals and a 1:1 randomized sample of the foreign journals were included. The primary outcome was the number of citations through the end of 2011. Subgroup analysis included language. The secondary outcome included likelihood of citation (cited at least once versus no citation), and presence or absence of CONSORT statement indicators. The citation counts were statistically significantly higher (Pjournals of ophthalmology still are low when compared with the foreign journals of ophthalmology with highest Impact Factor®.
Lu, Wenli; de Bock, Geertruida H; Schaapveld, Michael; Baas, Peter C; Wiggers, Theo; Jansen, Liesbeth
Routine physical examination is recommended in follow up guidelines for women with a history of breast cancer. The objective of this paper is to assess the contribution of routine physical examination in addition to mammography in the early diagnosis of breast cancer recurrences. The medical follow-up documents of 669 patients were reviewed. 127 contra-lateral breast cancers (CBCs) and 58 loco-regional recurrences (LRRs) in 163 patients were included. The additional contribution of routine physical examination over mammography was evaluated with the proportions of CBCs or LRRs detected by physical examination alone. χ(2) tests were used to compare the difference of contribution of physical examination among subgroups. Seven (6%) out of 127 CBCs and 13 (22%) out of 58 LRRs were detected by routine physical examination alone. Six LRRs (17%; 6/35) were in patients after breast conserving surgery and seven LRRs (30%; 7/23) in patients after mastectomy. There was a trend that the contribution of physical examination is higher in women under 60 years of age in the detection of CBCs (9%; 5/57) and LRRs (28%, 8/29) than in women over 60 years of age (CBCs:3%; 2/70 and LRRs:17%, 5/29; χ(2)=3.090, P=0.079). Twenty-two percent of loco regional breast cancer recurrences would have been detected later without physical examination. Routine physical examination may be most valuable for women with a history of breast cancer younger than 60 years at follow-up visit. Copyright © 2010 Elsevier Ltd. All rights reserved.
Sarah A Inskip
Full Text Available We have examined a 5th to 6th century inhumation from Great Chesterford, Essex, UK. The incomplete remains are those of a young male, aged around 21-35 years at death. The remains show osteological evidence of lepromatous leprosy (LL and this was confirmed by lipid biomarker analysis and ancient DNA (aDNA analysis, which provided evidence for both multi-copy and single copy loci from the Mycobacterium leprae genome. Genotyping showed the strain belonged to the 3I lineage, but the Great Chesterford isolate appeared to be ancestral to 3I strains found in later medieval cases in southern Britain and also continental Europe. While a number of contemporaneous cases exist, at present, this case of leprosy is the earliest radiocarbon dated case in Britain confirmed by both aDNA and lipid biomarkers. Importantly, Strontium and Oxygen isotope analysis suggest that the individual is likely to have originated from outside Britain. This potentially sheds light on the origins of the strain in Britain and its subsequent spread to other parts of the world, including the Americas where the 3I lineage of M. leprae is still found in some southern states of America.
Wiethölter, S; Steube, D; Stotz, H P
The syndrome of intra-vitreous bleeding in association with subarachnoid hemorrhage (SAH) was first described by the French ophthalmologist Albert Terson. In the last 10 years, 31 articles describing 202 cases of Terson's syndrome (TS) were published. Only 3 out of the 31 were printed in non-ophthalmological journals. The findings of our prospective study underline the fact that too little attention is paid to TS in the early treatment of patients with SAH. Between 1/95 and 8/97, 89 patients with spontaneous SAH (7% of all admissions) were transferred to our hospital for post acute phase rehabilitation. Out of these, 13 patients (19 eyes) could be diagnosed with TS. This corresponds to an incidence of 14.6% of all patients with SAH (previous studies: 2-27%). However, only one patient had been correctly diagnosed with TS in the referring clinic. Early recognition of TS is of high importance since diminuation of visual acuity even to functional blindness, complicated in the bilateral case, can hamper the rehabilitative process considerably. Moreover, complications can lead to significant and irreversible damage, i.e. proliferative vitreo-retinopathy (PVR), retinal breaks, traction amotio, and cataract. Suspicion of TS is raised in either cooperative patients complaining of compromised visual acuity or in patients where funduscopy shows vitreous opacity. According to our results, visual evoked potentials (VEP) have only a limited role in diagnosis because of their low sensitivity. Not infrequently, however, VEP may point to accompanying optic nerve atrophy, thereby suggesting conservative treatment. Absolute indications for surgical interventions are PVR and its sequelae; relative indications are subjective visual impairment, impediment of rehabilitation, or lack of spontaneous resorption of the hemorrhage. The surgical procedure of choice is the pars plana vitrectomy (PPV). Rare complications of this operation are retinal damage, endophthalmitis, and reoccurrence of
Bingham, Gary E.; Culatta, Barbara; Hall-Kenyon, Kendra M.
This study examined teachers' implementation of an early literacy intervention, Systematic and Engaging Early Literacy (SEEL), on kindergarten children's development of early literacy skills. One hundred forty-nine kindergarten children (102 treatment) across six classrooms participated in this study. Results reveal that children who received SEEL…
Abbas, Hafsa; Imran, Saira; Waris, Noorul-ain-Hafeez; Khanam, Andleeb; Khurshid, Rukshshan
The spectrum of breast lesions in adolescents varies markedly from that for adults, with the former lesions being overwhelmingly benign. Fine needle biopsy can be used to distinguish benign and malignant tumour. This study examined the characteristics and outcome of women with different age groups in whom physical examination was their sole method of lump in breast detection. A total of 200 patients were included in the study. These were divided into 3 groups. Group A was consisting of 75 girls with age of pubescent. Group B included 69 suspected breast cancer women with age range 26-38 years. Fifty-six suspected breast cancer women with age range 41-60 year were included as group C. Study was carried out in patients admitted in the Department/Out-door of Surgery, Sir Ganga Ram Hospital, Lahore, Pakistan. Study period was 6 months. All women received a physical examination by a breast surgeon. Proforma including demographic and clinical characteristics were filled. The diagnosis for patients in this study was achieved by core needle biopsy using a 14-gauge cutting needle. It was observed that early age at menarche (25 may be a risk factor in peri/post menopausal women. Active life style is more important with increasing age as it decreases the risk of developing tumour state. Family history was more common in women with peri/post menopausal status as compared to other age groups. Clinical characteristics showed that lump size early detection or clinical examination with FNA cut out the patients from harassment of malignancy and complications especially in the pubescent age. It is also found that Physical examination remain the useful indicators of prognosis in diagnosing cancer. Further research is needed to fully understand the reasons for variations in breast disease outcomes i.e. malignant or benign.
Coroneo, Minas T
Human ingenuity is challenged by defending vision, our highest bandwidth sense. Special challenges are presented by the replacement or repair of highly specialized but scarce tissue within the constraints of transparency, tissue shape and alignment, tissue borders and pressure maintenance. Many, mostly destructive, surgical procedures were developed prior to an understanding of underlying pathophysiology. For a number of conditions, both reconstructive and destructive procedures co-exist, yet there are few guidelines as to the better approach. Because the consequences of these procedures may take many years to surface (consistent with a stem cell role in long-term tissue maintenance), guidance may be provided by the elucidation of underlying principles from these approaches. Illustrative examples from clinical, basic research and biotechnology, particularly relating to pterygium, ocular surface squamous neoplasia, dry-eye syndrome, corneal rehabilitation and replacement, cataract surgery, strabismus surgery and bionic eye research, are described. An unexpected consequence of bionic device development has been an appreciation of the sophistication of tissues being replaced, given the limitations of available biomaterials. Examples of how this has provided insights into ocular disease will be illustrated. Stem cell and biomaterial technologies are starting to impact at a time when cost-effectiveness is under scrutiny. Both efficacy and cost will need to be considered as these interventions are introduced. It appears that the paradigm shift rate is accelerating and there is evidence of this in ophthalmology. Lessons learned from the areas of destructive versus reconstructive surgery and the limitations of development of bionic replacements will be used to illustrate how new procedures and technologies can be developed. © 2017 Royal Australian and New Zealand College of Ophthalmologists.
Full Text Available OBJECTIVE: To analyze the clinical and ophthalmological findings of patients with nevus of Ota. METHODS: Retrospective analysis of patients' charts with nevus of Ota. We registered the demographic data, location of the nevus and date of appearance, family history of similar spots, biomicroscopic, gonioscopic, tonometric, ophthalmoscopic and perimetric findings. RESULTS: We included 14 patients, six (43.0% men and eight (57.0% women, with a mean age of 21.7Â±17.5 years. Ten (71% were mulatto, three (21.4% white and one (7.1% black. Twelve (85.7% patients presented the spots at birth and two in puberty. Nine patients presented conjunctival and episcleral pigmentation in the right eye and five in the left eye. According to Tanino's classification, five (35.7% nevi were class 1, eight (57.1% class 2 and one (7.1% class 3. Heterochromia iridis was found in eight (57.1% patients. Anisocoria was present in three (21.4% patients. Five (35.7% patients presented a suspected glaucomatous cup disc ratio (â‰¥0.7; six (42.9% presented a cup disc ratio â‰¤ 0.5 and three (21.4%, no cup disc. We found two curious and remarkable findings: a nevus of Ota on the palate of one patient and other on the optic disc associated with a pigmentary mottling of the fundus in another patient. The pigmentary mottling of the fundus was also seen in four more eyes. CONCLUSIONS: The nevus of Ota was frequently present at birth, in mulattos, and classified as Tanino's class 1 and 2. Heterochromia iridis was a common finding. Anisocoria was present in a small percentage of eyes. No patient developed glaucoma or malignancy.
Dersee, T; Koehnlein, W; Kuni, H; Lengfelder, E; Pflugbeil, S; Schmitz-Feuerhake, I
Many experts find it difficult to accept what experience has shown, namely that routine mammography examinations have lowered neither the breast cancer fatality rate nor the crude death rate. One aspect that has been neglected in propagating screenings is the high radiation sensitivity of genetically predisposed females (0.5% - 1.0%). These females should not be exposed to repeated X-rays for screening purposes. True preventive measures, which promise significant effects, include the avoidance of radiation exposure, especially during the early stages of life, and a restrictive use of oestrogen substitution therapies.
Kortüm, K; Kernt, M; Reznicek, L
Over the past years, a significant progress in genetic, functional and imaging diagnostics in hereditary retinal diseases has been made. Optical coherence tomography (OCT) as well as fundus autofluorescence (FAF) allow for high-resolution, non-invasive imaging - from various perspectives - of retinal and choroidal layers of the posterior fundus. Both techniques have gained more and more significance in the diagnosis of hereditary retinal diseases. Of all patients presented in this review, extensive family history was taken and a clinical ophthalmological examination performed. OCT scans as well as FAF images were acquired and compared to results of other functional and molecular genetic tests in the context of each disease. The presented cases in this review addressing hereditary retinal diseases (Best's disease, Stargardt's disease, cone-rod dystrophy, retinitis pigmentosa, achromatopsia, and X-linked retinoschisis) show the significance of ophthalmic imaging (OCT + FAF) for a targeted diagnosis of hereditary retinal diseases. The described imaging techniques (OCT + FAF) are becoming more and more important in the diagnosis of hereditary retinal diseases. Due to increasing availability of the devices, earlier detection of typical morphological changes not seen in clinical fundoscopy is feasible. Georg Thieme Verlag KG Stuttgart · New York.
Wei, Zhuo; Wu, Yongdong; Deng, Robert H; Yu, Shengsheng; Yao, Haixia; Zhao, Zhigang; Ngoh, Lek Heng; Han, Lim Tock; Poh, Eugenie W T
This paper describes a secure and synthesis ophthalmology telemedicine system, referred to as TeleOph. Under a Secure Socket Layer (SSL) channel, patient prerecorded data can be safely transferred via the Internet. With encrypted videoconference and white-board, the system not only supports hospital-to-clinic consultation, but also supplies hospital-tohospital joint discussion. Based on Directshow technology (Microsoft Corporation, Redmond, WA), video cameras connected to the computer by firewire can be captured and controlled to sample video data. By using TWAIN technology, the system automatically identifies networked still cameras (on fundus and slitlamp devices) and retrieves images. All the images are stored in a selected format (such as JPEG, DICOM, BMP). Besides offline-transferring prerecorded data, the system also supplies online sampling of patient data (real-time capturing from remote places). The system was deployed at Tan Tock Seng Hospital, Singapore and Ang Mo Kio, Singapore, where 100 patients were enrolled in the system for examination. TeleOph can be successfully used for patient consultation, and hospital joint discussion. Meanwhile, TeleOph can supply both offline and online sampling of patient data.
Ricardo Salles Cauduro
Full Text Available Purpose. Application of anterior segment optical coherence (AS-OCT in pediatric ophthalmology. Methods. Retrospective clinical study case series of 26 eyes of 19 pediatric patients throughout a 21-month period, presenting anterior segment pathologies, were submitted to AS-OCT examination (OCT Visante, 1310 nm, Zeiss, noncontact technique, no sedation requirement. Results. AS-OCT images were obtained from 19 patients (range: 2 months to 12 years. Clinical diagnosis of anterior segment abnormalities included cornea disease (n=7, congenital anterior segment conditions (n=10, ocular trauma (n=1, anterior segment surgeries (n=2, iridocorneal angle abnormalities (n=4, intermediate uveitis (n=2. The most common OCT findings were corneal hyperreflectivity and thickening (n=15, shallow anterior chamber with iris-lens diaphragm anterior displacement (n=4, atypical corneal curvature (n=4, corneal thinning (n=4, peripheral synechiae with angle closure (n=3, increased anterior chamber depth (n=2, and proximal portion of glaucoma drainage tube (n=2. Conclusion. In the present study, noncontact AS-OCT demonstrated to be a feasible technique to evaluate the anterior segment providing anatomic details and useful to clarify diagnosis in the pediatric population.
Chilenski, Sarah M
This study examined how multiple dimensions and levels of the community context associated with early adolescent problem behaviors in rural communities. Four thousand, five hundred and nine eighth-grade students in 28 rural and small town school districts in two states participated in surveys regarding substance use and delinquency in 2005. Locations of alcohol retailers, tobacco retailers, youth-serving organizations, and student residences were geocoded. Associations of the number of proximal alcohol and tobacco retailers, and youth-serving organizations with an early-adolescent problem behavior index were tested in Nonlinear Mixed Models that controlled for multiple district-level and individual characteristics. Multi-level model results demonstrated that the number of alcohol and tobacco retail locations within a one-mile radius of each adolescent's home positively associated with student-reported problem behaviors above and beyond the influence of school district and individual characteristics. Results suggest that the proximal community context added significantly to the district context when understanding the occurrence of early adolescent problem behaviors. Recognizing this variability in geographically determined risk within a community will likely enhance the effectiveness of community prevention activities.
Williams, Summer; Wajda, Brynn N; Alvi, Rizwan; McCauley, Colleen; Martinez-Helfman, Sarah; Levin, Alex V
To identify barriers to ophthalmological follow-up in high-risk children who are identified by vision screening and eye examination. The records of patients identified as needing follow-up through two free eye care programs (organized optometric and ophthalmologic screening sessions aimed at identifying and treating ocular pathology) targeted toward inner-city youths of low socioeconomic status were reviewed. Parents were contacted by phone, and a questionnaire on barriers to follow-up was administered. Callers attempted to schedule appointments at that time. Data were assessed by means of descriptive analysis. Of 93 patients, 54 (58%), were successfully contacted. Of these, 23 (25%) were eventually scheduled. Five (5%) patients elected follow-up elsewhere. Twenty (22%) with working phones were still unable to be scheduled. Additional obstacles included families' lack of awareness of the need for follow-up (13%), assumption by families that they would be contacted (5%), scheduling conflicts (4%), concerns about insurance, and difficulty finalizing referrals (2%). A total of 39 patients (42%) were not successfully contacted because of inoperable phone services, and none of the families responded to the mailed questionnaire. Inability to contact families was the greatest barrier to follow-up. Our findings suggest that immediate arrangement of follow-up care, on-site visual assessment, and a program director may be useful in increasing follow-up for high-risk children. Copyright © 2013 American Association for Pediatric Ophthalmology and Strabismus. Published by Mosby, Inc. All rights reserved.
Jafar Rafiei Kiasari
Full Text Available Introduction: Anxiety is a common disorder in patients before surgery. Inappropriately managed anxiety can cause psychological and physiological reactions and will affect the process of surgery and recovery. Therefore, this study examined the effects of hand mas-sage on anxiety in patients undergoing ophthalmology surgery using local anesthesia. Methods: In this interventional study, 52 patients who were supposed to undergo oph-thalmology surgery using local anesthesia were studied. Patients were randomly as-signed to two groups of intervention, who received hand massage before surgery (n = 27 and control (n = 25. Massaging lasted for 5 minutes (2.5 minutes on each hand before surgery. Stroking and scrubbing methods were performed by 2 trained research-ers. Anxiety level, blood pressure, heart rate, and respiratory rate were measured before and after the intervention in both groups. Anxiety was evaluated using Spielberger State-Trait Anxiety Inventory. Data was analyzed by chi-square, independent samples t-test, and paired t-test. Results: There were no significant differences in mean anxiety, systolic blood pressure, diastolic blood pressure, heart rate, and respiratory rate between the two groups before the intervention (p > 0.05. However, there was a significant differenc in the mean stress level between the two groups after the intervention (p 0.05. Conclusion: Our findings suggested that 5 minutes of hand massage before ophthalmology surgery (under local anesthesia could reduce anxiety. Therefore, this method can be used to increase patient comfort and reduce anxiety before surgical interventions.
Full Text Available Purpose: To assess the feasibility of making a diagnosis of adnexal and orbital diseases by Tele-ophthalmological means. Materials and Methods: Tele-consultation for eye diseases was done for 3497 patients from remote areas of Tamilnadu as part of the rural tele-ophthalmology project of a tertiary eye care hospital during a period of nine months from October 2004 to June 2005. These patients were comprehensively examined on-site by optometrists. Using digitized images sent by store and forward technique and videoconferencing, the ophthalmologist made a diagnosis and advised treatment. Results: Adnexal or orbital diseases were detected in 101 out of 3497 patients (2.88%. Medical treatment was advised to 13 of 101 patients (12.8%. Surgery was advised in 62 of 101 patients (61.28% whereas 18 of 101 patients (17.8% required further investigations at a tertiary center. Conclusion: It was feasible to apply the satellite based tele-ophthalmology set-up for making a presumptive diagnosis and planning further management of adnexal and orbital diseases based on live interaction and digital still images of the patients.
Gurwin, Jaclyn; Revere, Karen E; Niepold, Suzannah; Bassett, Barbara; Mitchell, Rebecca; Davidson, Stephanie; DeLisser, Horace; Binenbaum, Gil
Observation and description are critical to the practice of medicine, and to ophthalmology in particular. However, medical education does not provide explicit training in these areas, and medical students are often criticized for deficiencies in these skills. We sought to evaluate the effects of formal observation training in the visual arts on the general and ophthalmologic observational skills of medical students. Randomized, single-masked, controlled trial. Thirty-six first-year medical students, randomized 1:1 into art-training and control groups. Students in the art-training group were taught by professional art educators at the Philadelphia Museum of Art, during 6 custom-designed, 1.5-hour art observation sessions over a 3-month period. All subjects completed pre- and posttesting, in which they described works of art, retinal pathology images, and external photographs of eye diseases. Grading of written descriptions for observational and descriptive abilities by reviewers using an a priori rubric and masked to group assignment and pretesting/posttesting status. Observational skills, as measured by description testing, improved significantly in the training group (mean change +19.1 points) compared with the control group (mean change -13.5 points), P = 0.001. There were significant improvements in the training vs. control group for each of the test subscores. In a poststudy questionnaire, students reported applying the skills they learned in the museum in clinically meaningful ways at medical school. Art observation training for first-year medical students can improve clinical ophthalmology observational skills. Principles from the field of visual arts, which is reputed to excel in teaching observation and descriptive abilities, can be successfully applied to medical training. Further studies can examine the impact of such training on clinical care. Copyright © 2017 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.
Gharaibeh, Almutez M; Mezer, Eedy; Ospina, Luis H; Wygnanski-Jaffe, Tamara
To compile international data on the risk factors, diagnosis, and treatment of endophthalmitis following pediatric cataract surgery. An e-mail containing a link to an online survey was sent to all members of the American Association for Pediatric Ophthalmology and Strabismus. The questionnaire examined the incidence, risk factors, treatment, outcomes, and prophylaxis of endophthalmitis following pediatric cataract surgery around the world. Two hundred thirty-seven ophthalmologists answered the questionnaire. Eight ophthalmologists (3.4%) encountered 22 cases of endophthalmitis following pediatric cataract surgery during their practice. Most patients with endophthalmitis following pediatric cataract surgery were 2 to 4 years of age (36.4%). An intraocular lens was implanted in 59.1% of cases, most of which were acrylic intraocular lenses (53.8%). The main presenting symptoms were photophobia (50%) and pain (40.9%). The most common signs were conjunctival injection (36.4%) and hypopyon (31.8%). The final visual acuity was counting fingers or worse in 86% of cases. The most common cultured organism was Staphylococcus aureus (31.8%). The most common management of endophthalmitis following pediatric cataract surgery was a combination of intravitreal, systemic, and topical antibiotics (36.4%). Most ophthalmologists (68.2%) administered prophylactic intracameral antibiotic treatment during surgery and 50% used vancomycin. Endophthalmitis following pediatric cataract surgery is an uncommon, multifactorial complication with poor visual prognosis. Efforts directed at minimizing its risk, such as treating potential predisposing systemic conditions, improving sterilization techniques, optimizing operative conditions to reduce complications and surgery duration, and using subconjunctival and intracameral antibiotics, decrease its incidence. Early postoperative evaluation, subsequent follow-up visits, and keeping a high index of suspicion should facilitate the recognition of
Mortensson, W. (St. Goeran' s Children' s Hospital, Stockholm (Sweden). Dept. of Diagnostic Radiology); Andreasson, B.; Lindroth, M.; Svenningsen, N. (Lund Univ. (Sweden). Dept. of Pediatrics); Jonson, B. (Lund Univ. (Sweden). Dept. of Clinical Physiology)
The potentiality of early chest X-ray to predict the risk of lung function abnormalities was studied prospectively in 40 preterm ventilator treated infants in a 8-10-year follow-up investigation. According to the findings at chest X-ray 3 to 10 days after completed ventilator treatment the infants were divided into 3 groups considered to respresent increasing risk and severity of lung damage: (1) normal findings, (2) interstitial parenchymal abnormalities exclusively or (3) in combination with local or general hyperinflation. Lung function tests and chest X-ray were performed at the age of 8 to 10 years. A correlation was found between the findings at the early chest roentgen examination and the risk of abnormal lung function at the follow-up. Occurrence of focal or general hyperinflation or both were associated with a greater risk of airway obstruction. Infants with only interstitial abnormalities were, however, at a higher risk than those with normal chest examination to develop general hyperinflation and increased air way obstruction. (orig.).
Foo, Chee Yoong; Lim, Ka Keat; Sivasampu, Sheamini; Dahian, Kamilah Binti; Goh, Pik Pin
Rising demand of ophthalmology care is increasingly straining Malaysia's public healthcare sector due to its limited human and financial resources. Improving the effectiveness of ophthalmology service delivery can promote national policy goals of population health improvement and system sustainability. This study examined the performance variation of public ophthalmology service in Malaysia, estimated the potential output gain and investigated several factors that might explain the differential performance. Data for 2011 and 2012 on 36 ophthalmology centres operating in the Ministry of Health hospitals were used in this analysis. We first consulted a panel of ophthalmology service managers to understand the production of ophthalmology services and to verify the production model. We then assessed the relative performance of these centres using Data Envelopment Analysis (DEA). Efficiency scores (ES) were decomposed into technical, scale, and congestion component. Potential increase in service output was estimated. Sensitivity analysis of model changes was performed and stability of the result was assessed using bootstrap approach. Second stage Tobit regression was conducted to determine if hospital type, availability of day services and population characteristics were related to the DEA scores. In 2011, 33% of the ophthalmology centres were found to have ES > 1 (mean ES = 1.10). Potential output gains were 10% (SE ± 2.92), 7.4% (SE ± 2.06), 6.9% (SE ± 1.97) if the centres could overcome their technical, scale and congestion inefficiencies. More centres moved to the performance frontier in 2012 (mean ES = 1.07), with lower potential output gain. The model used has good stability. Robustness checks show that the DEA correctly identified low performing centres. Being in state hospital was significantly associated with better performance. Using DEA to benchmarking service performance of ophthalmology care could provide insights for policy
Full Text Available Team-based learning (TBL is an increasingly popular teaching method in medical education. However, TBL hasn't been well-studied in the ophthalmology clerkship context. This study was to examine the impact of modified TBL in such context and to assess the student evaluations of TBL.Ninety-nine students of an 8-year clinical medicine program from Zhongshan Ophthalmic Centre, Sun Yat-sen University, were randomly divided into four sequential units and assigned to six teams with the same faculty. The one-week ophthalmology clerkship module included traditional lectures, gross anatomy and a TBL module. The effects of the TBL module on student performance were measured by the Individual Readiness Assurance Test (IRAT, the Group Readiness Assurance Test (GRAT, the Group Application Problem (GAP and final examination scores (FESs. Students' evaluations of TBL were measured by a 16-item questionnaire. IRAT and GRAT scores were compared using a paired t-test. One-way analysis of variance (ANOVA and subgroup analysis compared the effects among quartiles that were stratified by the Basic Ophthalmology Levels (BOLs. The BOLs were evaluated before the ophthalmology clerkship.In TBL classes, the GRAT scores were significantly higher than the IRAT scores in both the full example and the BOL-stratified groups. It highlighted the advantages of TBL compared to the individual learning. Quartile-stratified ANOVA comparisons showed significant differences at FES scores (P < 0.01. In terms to IRAT, GRAT and GAP scores, there was no significant result. Moreover, IRAT scores only significantly differed between the first and fourth groups. The FES scores of the first three groups are significantly higher than the fourth group. Gender-specific differences were significant in FES but not the IRAT. Overall, 57.65% of student respondents agreed that TBL was helpful. Male students tended to rate TBL higher than female students.The application of modified TBL to the
Carson, Valerie; Clark, Marianne; Berry, Tanya; Holt, Nicholas L; Latimer-Cheung, Amy E
Minimizing sedentary behavior, in particular screen-based sedentary behavior, during the early years is important for healthy growth and development. Consequently, new Canadian Sedentary Behaviour Guidelines for the Early Years (aged 0-4 years) were recently released. Researchers are unclear what messages should supplement the guidelines when disseminating them to parents and when using the guidelines in behaviour-change interventions to increase adoption. The objective of this study was to qualitatively examine parents' perceptions of the new Canadian Sedentary Behaviour Guidelines for the Early Years. Parents with a child ≤4 years who attended a child care centre were purposefully recruited from child care centres. A total of 7 semi-structured focus groups with 2 to 5 parents were conducted from August to November, 2013 by a trained and experienced moderator. Participants were asked a series of open-ended questions pertaining to the Sedentary Behaviour Guidelines information sheet. Initial themes were identified followed by further review and analysis. For the most part parents thought the guidelines were clear and did not disagree with the recommendations per se. However, some confusion arose around the value of some sedentary activities, such as reading and coloring, for social and cognitive development. Many parents described feeling guilty after reading the guidelines and perceived several barriers in meeting the daily recommendations. Common barriers included the need to balance multiple demands of family life, the prevalence and accessibility of screen technology, and the weather and built environment where families live. Parents expressed the importance of communicating the guidelines early enough for good habits to be established and the need for realistic strategies and ideas to help them meet the recommendations. Overall the findings indicate that gain-framed messages around the role of screen-based and non-screen-based sedentary behavior for children
Daniel Shu Wei Ting
Full Text Available This is a review education paper on the current ophthalmology simulators utilized worldwide for undergraduate and postgraduate training. At present, various simulators such as the EYE Exam Simulator (Kyoto Kagaku Co. Ltd., Kyoto, Japan, Eyesi direct ophthalmoscope simulator (VRmagic, GmbH, Mannheim, Germany, Eyesi indirect ophthalmoscope simulator (VRmagic, GmbH, Mannheim, Germany and Eyesi cataract simulators (VRmagic, GmbH, Mannheim, Germany. These simulators are thought to be able to reduce the initial learning curve for the ophthalmology training but further research will need to be conducted to assess the effectiveness of the simulation-assisted Ophthalmology training. Future research will be of great value to assess the medical students and residents’ responses and performance regarding the usefulness of the individual eye simulator.
Ting, Daniel Shu Wei; Sim, Shaun Sebastian Khung Peng; Yau, Christine Wen Leng; Rosman, Mohamad; Aw, Ai Tee; Yeo, Ian Yew San
This is a review education paper on the current ophthalmology simulators utilized worldwide for undergraduate and postgraduate training. At present, various simulators such as the EYE Exam Simulator (Kyoto Kagaku Co. Ltd., Kyoto, Japan), Eyesi direct ophthalmoscope simulator (VRmagic, GmbH, Mannheim, Germany), Eyesi indirect ophthalmoscope simulator (VRmagic, GmbH, Mannheim, Germany) and Eyesi cataract simulators (VRmagic, GmbH, Mannheim, Germany). These simulators are thought to be able to reduce the initial learning curve for the ophthalmology training but further research will need to be conducted to assess the effectiveness of the simulation-assisted Ophthalmology training. Future research will be of great value to assess the medical students and residents' responses and performance regarding the usefulness of the individual eye simulator.
Schwartz, Daniel P; Robbins, Matthew S
Headache is an extraordinarily common complaint presenting to medical practitioners in all arenas and specialties, particularly primary care physicians, neurologists, and ophthalmologists. A wide variety of headache disorders may manifest with a myriad of neuro-ophthalmologic symptoms, including orbital pain, disturbances of vision, aura, photophobia, lacrimation, conjunctival injection, ptosis, and other manifestations. The differential diagnosis in these patients is broad and includes both secondary, or symptomatic, and primary headache disorders. Awareness of the headache patterns and associated symptoms of these various disorders is essential to achieve the correct diagnosis. This paper reviews the primary headache disorders that prominently feature neuro-ophthalmologic manifestations, including migraine, the trigeminal autonomic cephalalgias, and hemicrania continua. Migraine variants with prominent neuro-ophthalmologic symptoms including aura without headache, basilar-type migraine, retinal migraine, and ophthalmoplegic migraine are also reviewed. This paper focuses particularly on the symptomatology of these primary headache disorders, but also discusses their epidemiology, clinical features, and treatment. PMID:28539781
Nentwich, M M; Klauß, V; Guthoff, R
In 1999 the global initiative "Vision 2020 - The Right to Sight" was established by the World Health Organization (WHO), the International Agency for the Prevention of Blindness (IAPB) and several non-governmental organizations (NGOs) with the goal of reducing avoidable blindness. Based on this initiative, the working group "International Ophthalmology" of the German Ophthalmological Society (DOG), which was established in 1994, was converted into a DOG section with the same name in 2004 and represents one of the core components of the DOG; however, even before there were a number of established partnerships of German and African eye hospitals. The first cooperation of this kind was the partnership between the Department of Ophthalmology, Ludwig-Maximilians University Munich and the University of Nairobi, Kenya, which was founded in 1978. As a result of this cooperation, the Department of Ophthalmology in Nairobi has evolved into one of the major centers of ophthalmological training and ophthalmic care in East Africa. Since then a number of similar cooperation projects between several hospitals and numerous further projects (e. g. in Myanmar) have been implemented and some of these are presented in this manuscript.
Full Text Available A cross-sectional clinical trial in which the serum anti-phenolic glycolipid (anti-PGL-1 antibodies were analysed in household contacts (HHC of patients with leprosy as an adjunct early leprosy diagnostic marker was conducted. The families of 83 patients underwent clinical examination and serum anti-PGL1 measurement using enzyme-linked immunosorbent assay. Of 320 HHC, 98 were contacts of lepromatous leprosy (LL, 80 were contacts of borderline lepromatous (BL, 28 were contacts of borderline (BB leprosy, 54 were contacts of borderline tuberculoid (BT, 40 were contacts of tuberculoid (TT and 20 were contacts of indeterminate (I leprosy. Consanguinity with the patients was determined for 232 (72.5% HHC. Of those 232 contacts, 183 had linear consanguinity. Forty-nine HHC had collateral consanguinity. Fifty-eight contacts (18.1% tested positive for anti-PGL1 antibodies. The number of seropositive contacts based on the clinical forms of the index case was 17 (29.3% for LL, 15 (25.9% for BL, one (1.7% for BB, 14 (24.1% for BT, three (5.2% for TT and eight (13.7% for I. At the one year follow-up, two (3.4% of these seropositive contacts had developed BT leprosy. The results of the present study indicate that the serum anti-PGL-1 IgM antibody may be useful for evaluating antigen exposure and as a tool for an early leprosy diagnosis in HHC.
Rodrigo Pessoa Cavalcanti Lira
Full Text Available PURPOSE: To compare clinical trials published in Brazilian journals of ophthalmology and in foreign journals of ophthalmology with respect to the number of citations and the quality of reporting [by applying the Consolidated Standards for Reporting Trials (CONSORT statement writing standards]. METHODS: The sample of this systematic review comprised the two Brazilian journals of ophthalmology indexed at Science Citation Index Expanded and six of the foreign journals of ophthalmology with highest Impact Factor® according ISI. All clinical trials (CTs published from January 2009 to December 2010 at the Brazilians journals and a 1:1 randomized sample of the foreign journals were included. The primary outcome was the number of citations through the end of 2011. Subgroup analysis included language. The secondary outcome included likelihood of citation (cited at least once versus no citation, and presence or absence of CONSORT statement indicators. RESULTS: The citation counts were statistically significantly higher (P<0.001 in the Foreign Group (10.50 compared with the Brazilian Group (0.45. The likelihood citation was statistically significantly higher (P<0.001 in the Foreign Group (20/20 - 100% compared with the Brazilian Group (8/20 - 40%. The subgroup analysis of the language influence in Brazilian articles showed that the citation counts were statistically significantly higher in the papers published in English (P<0.04. Of 37 possible CONSORT items, the mean for the Foreign Group was 20.55 and for the Brazilian Group was 13.65 (P<0.003. CONCLUSION: The number of citations and the quality of reporting of clinical trials in Brazilian journals of ophthalmology still are low when compared with the foreign journals of ophthalmology with highest Impact Factor®.
Müller, M; Pavlovic, I; Schmack, I; Ohrloff, C; Kohnen, T
There are various developments and inventions from Germany that have influenced not only the domestic but also the international field of ophthalmology. Beginning with the invention of the ophthalmoscope by Hermann von Helmholtz in 1850, to the establishment of the "Archives of Ophthalmology" medical journal, a publication founded by Albrecht von Graefe in 1854, through to the development of the retinal chip by Eberhart Zrenner and colleagues with the first clinical data collected in 2007. The abovenamed and further developments and the German ophthalmologists behind these inventions are discussed in more detail.
Zhao-Tian Zhang; Yan-Tao Wei; Xin-Tong Jiang; Yuan-Zhe Yang; Suo Qiu; Shao-Chong Zhang
AIM:To identify and categorize ophthalmology-relevant apps for the iPad tablet computer as a source for ophthalmic practices on the Apple's App Store.METHODS: The Apple's App Store was searched for ophthalmology-relevant apps from January 2013 to August 2013. Eligible apps were identified and downloaded into the iPad tablet computers, and then categorized according to the apps' initial contents and our using experiences. Methods about how to use the iPad's built-in functions of instant video ...
Full Text Available Smart phones as a symbol of the mobile Internet appears in college classroom, which is not only a challenge, but also a great opportunities of education information. This paper applied smart phones as the carrier of the "Internet" into ophthalmology classroom. Smart phones has a lot of features, such as rich teaching resources, diverse learning methods, flexible learning time, collating and recording capabilities and the timely, comprehensive and accurate teaching feedback so on, and could be used in case teaching and interactive teaching. The implementation of smart phones into ophthalmology classroom could inspire the learning enthusiasm of the students, enhance the quality of teaching, eventually improve teaching effects.
Huang, Wenbin; Zhang, Xiulan
The three-dimensional (3D) printer is a new technology that creates physical objects from digital files. Recent technological advances in 3D printing have resulted in increased use of this technology in the medical field, where it is beginning to revolutionize medical and surgical possibilities. It is already providing medicine with powerful tools that facilitate education, surgical planning, and organ transplantation research. A good understanding of this technology will be beneficial to ophthalmologists. The potential applications of 3D printing in ophthalmology, both current and future, are explored in this article. Copyright 2014 The Association for Research in Vision and Ophthalmology, Inc.
conjunctivitis. Corneal ulceration (9.2%) and perforation. (4.1%) are major causes of ocular morbidity and. Author for correspondence blindness (6.1%), among patients with conjunctivitis as seen in Ile-Ife. There is a need for public eye health education and early referral of all cases of eye infections to an eye specialist to ...
Lee, Andrew G.; Beaver, Hilary A.; Greenlee, Emily; Oetting, Thomas A.; Boldt, H. Culver; Olson, Richard; Abramoff, Michael; Carter, Keith
The Accreditation Council for Graduate Medical Education (ACGME) has mandated that residency programs, including ophthalmology, teach and assess specific competencies, including systems-based learning. We review the pertinent literature on systems-based learning for ophthalmology and recommend
Trivier, D; Dubos, J P; Mteyrek, M; Codaccioni, X; Courcol, R J; Husson, M O
A prospective study was conducted in 3056 live-born infants delivered at the Jeanneade-Flandre maternity hospital of the Lille Teaching Hospital between January and August 1997. Clinical, laboratory test, and microbiological test findings were compared. A cohort of 1003 infants who remained in the maternity ward but were considered at increased risk of maternofetal infection (MFI) based on history and/or obstetrical criteria and/or neonatal criteria underwent routine collection of specimens including gastric fluid, auricular and anal swabs, amniotic fluid, and placental fragments. Microscopic examination of gastric fluid smears, the first result available to the clinician, was found to have 27.5% sensitivity (983 samples). Positive predictive value (PPV) was only 17.8% because of a high rate of colonization (16.8%), defined as absence of clinical symptoms and three peripheral specimens positive for the same organism. However, negative predictive value (NPV) was as high as 99.8% as a result of high sensitivity (97.8%) in the infected neonates. The gastric fluid smear was positive in 30% and 35% of neonates born to mothers with hyperpyrexia during early and late labor, respectively, and in 42% of neonates born to mothers with a history of group B streptococcus carriage during the pregnancy. Forty-two per cent of neonates with a history of fetal tachycardia had a positive gastric fluid smear. Diagnostic criteria for infection were three peripheral specimens positive for the same organism, C-reactive protein elevation, and/or one or more clinical signs suggestive of infection, and/or a positive central specimen (blood, CSF). The infection rate in infants who remained in the maternity ward was 1.6%. The most common causative organisms were group B streptococci. These findings illustrate the useful contribution of gastric fluid smears to the early diagnosis of MFI and confirm the predominant role of group B streptococci.
Skitch, Steven; Tam, Benjamin; Xu, Michael; McInnis, Laura; Vu, Anthony; Fox-Robichaud, Alison
Early warning scores use vital signs to identify patients at risk of critical illness. The current study examines the Hamilton Early Warning Score (HEWS) at emergency department (ED) triage among patients who experienced a critical event during their hospitalization. HEWS was also evaluated as a predictor of sepsis. The study population included admissions to two hospitals over a 6-month period. Cases experienced a critical event defined by unplanned intensive care unit admission, cardiopulmonary resuscitation, or death. Controls were randomly selected from the database in a 2-to-1 ratio to match cases on the burden of comorbid illness. Receiver operating characteristic (ROC) curves were used to evaluate HEWS as a predictor of the likelihood of critical deterioration and sepsis. The sample included 845 patients, of whom 270 experienced a critical event; 89 patients were excluded because of missing vitals. An ROC analysis indicated that HEWS at ED triage had poor discriminative ability for predicting the likelihood of experiencing a critical event 0.62 (95% CI 0.58-0.66). HEWS had a fair discriminative ability for meeting criteria for sepsis 0.77 (95% CI 0.72-0.82) and good discriminative ability for predicting the occurrence of a critical event among septic patients 0.82 (95% CI 0.75-0.90). This study indicates that HEWS at ED triage has limited utility for identifying patients at risk of experiencing a critical event. However, HEWS may allow earlier identification of septic patients. Prospective studies are needed to further delineate the utility of the HEWS to identify septic patients in the ED.
Objective: The study was embarked upon to determine the view of University of Nigeria final year medical students on the adequacy of their undergraduate training in ophthalmology, vis-à-vis rendering basic eye care as general duty doctors. Methods: One hundred final year medical students, who had finished their ...
Career paths have become very complex and variable in the field of ophthalmology. The common way of ophthalmologists in private practice is still a very popular model, especially with regard to the autonomy which has been missing for years in hospitals. It is still an attractive way but alternative developmental options which appear more exciting and flexible, are on the increase.
Full Text Available Daniel P Schwartz, Matthew S RobbinsDepartment of Neurology, Montefiore Headache Center, Albert Einstein College of Medicine, Bronx, NY, USAAbstract: Headache is an extraordinarily common complaint presenting to medical practitioners in all arenas and specialties, particularly primary care physicians, neurologists, and ophthalmologists. A wide variety of headache disorders may manifest with a myriad of neuro-ophthalmologic symptoms, including orbital pain, disturbances of vision, aura, photophobia, lacrimation, conjunctival injection, ptosis, and other manifestations. The differential diagnosis in these patients is broad and includes both secondary, or symptomatic, and primary headache disorders. Awareness of the headache patterns and associated symptoms of these various disorders is essential to achieve the correct diagnosis. This paper reviews the primary headache disorders that prominently feature neuro-ophthalmologic manifestations, including migraine, the trigeminal autonomic cephalalgias, and hemicrania continua. Migraine variants with prominent neuro-ophthalmologic symptoms including aura without headache, basilar-type migraine, retinal migraine, and ophthalmoplegic migraine are also reviewed. This paper focuses particularly on the symptomatology of these primary headache disorders, but also discusses their epidemiology, clinical features, and treatment.Keywords: headache, migraine, trigeminal autonomic cephalalgias, neuro-ophthalmologic, aura, photophobia
Transactions of the Ophthalmological Society of Nigeria: Proceedings of the annual OSN Conference, Jos, Nigeria, August 25–28, 2015. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · AJOL African Journals Online. HOW TO USE AJOL... for Researchers ...
Proceedings from the Ophthalmological Society of Nigeria Conference, 2014. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL ...
In most developing countries particularly in Nigeria, the paediatric ophthalmology subspecialty is still at its infancy especially in terms of human resources, equipment and infrastructure. It is therefore important to bring to notice the importance of creating a child friendly eye care environment while putting up an eye care unit.
Neuro-ophthalmology, as an interdisciplinary, covers at least three disciplines- ophthalmology, neurology and neurosurgery. With limited knowledge in each discipline, doctors often make misdiagnoses for neuro-ophthalmology diseases. Therefore, it is imperative to abandon the distinction between disciplines and combine all the knowledge to diagnose and treat patients in patterns of holistic integrated medicine in order to effectively improve the diagnosis and treatment of neuro-ophthalmology.
Huang, Grace; Fang, Christina H; Lopez, Santiago A; Bhagat, Neelakshi; Langer, Paul D; Eloy, Jean Anderson
To assess whether scholarly impact of academic ophthalmologists, as measured using the h-index, is affected by fellowship training status and to further characterize differences in productivity among the various subspecialties and by departmental rank. A descriptive and correlational design was used. In total, 1440 academic ophthalmologists from 99 ophthalmology training programs were analyzed. The h-index data were obtained from the Scopus database. Faculty members were classified by academic rank and grouped into 10 categories based on fellowship training: anterior segment, corneal and external disease, glaucoma, uveitis and ocular immunology, vitreoretinal disease, ophthalmic plastic surgery, pediatric ophthalmology, neuro-ophthalmology, ophthalmic pathology, and "other." A one-way analysis of variance or Student t test using Microsoft Excel and "R" statistical software were used for comparison of continuous variables, with significance set at p academic ophthalmology residency training programs in the United States whose information is stored in the American Medical Association's Fellowship and Residency Electronic Interactive Database. Fellowship-trained ophthalmologists had significantly higher research productivity, as measured using the h-index, than non-fellowship-trained ophthalmologists in this study (p Academic ophthalmologists trained in vitreoretinal disease or ophthalmic pathology had the highest scholarly productivity compared with those in other ophthalmology subspecialties (p academic rank from Assistant Professor to Professor (p Academic ophthalmologists with fellowship training have significantly higher scholarly output than non-fellowship-trained ophthalmologists do, as measured using the h-index. Research productivity increases with departmental academic rank from Assistant Professor to Professor. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.
Matsubara, Hiroko; Ishikuro, Mami; Kikuya, Masahiro; Chida, Shoichi; Hosoya, Mitsuaki; Ono, Atsushi; Kato, Noriko; Yokoya, Susumu; Tanaka, Toshiaki; Isojima, Tsuyoshi; Yamagata, Zentaro; Tanaka, Soichiro; Kuriyama, Shinichi; Kure, Shigeo
To investigate the impact of the Great East Japan Earthquake on preschool children's physical growth in the disaster-affected areas, the three medical universities in Iwate, Miyagi, and Fukushima Prefectures conducted a health examination survey on early childhood physical growth. The survey was conducted over a 3-year period to acquire data on children who were born in different years. Our targets were as follows: 1) children who were born between March 1, 2007 and August 31, 2007 and experienced the disaster at 43-48 months of age, 2) children who were born between March 1, 2009 and August 31, 2009 and experienced the disaster at 19-24 months of age, and 3) children who were born between June 1, 2010 and April 30, 2011 and were under 10 months of age or not born yet when the disaster occurred. We collected their health examination data from local governments in Iwate, Miyagi, and Fukushima Prefectures. We also collected data from Aomori, Akita, and Yamagata Prefectures to use as a control group. The survey items included birth information, anthropometric measurements, and methods of nutrition during infancy. Eighty municipalities from Iwate, Miyagi, and Fukushima Prefectures and 21 from the control prefectures participated in the survey. As a result, we established three retrospective cohorts consisting of 13,886, 15,474, and 32,202 preschool children. The large datasets acquired for the present survey will provide valuable epidemiological evidence that should shed light on preschool children's physical growth in relation to the disaster. Copyright © 2016 The Authors. Production and hosting by Elsevier B.V. All rights reserved.
Full Text Available Background: To investigate the impact of the Great East Japan Earthquake on preschool children's physical growth in the disaster-affected areas, the three medical universities in Iwate, Miyagi, and Fukushima Prefectures conducted a health examination survey on early childhood physical growth. Methods: The survey was conducted over a 3-year period to acquire data on children who were born in different years. Our targets were as follows: 1 children who were born between March 1, 2007 and August 31, 2007 and experienced the disaster at 43–48 months of age, 2 children who were born between March 1, 2009 and August 31, 2009 and experienced the disaster at 19–24 months of age, and 3 children who were born between June 1, 2010 and April 30, 2011 and were under 10 months of age or not born yet when the disaster occurred.We collected their health examination data from local governments in Iwate, Miyagi, and Fukushima Prefectures. We also collected data from Aomori, Akita, and Yamagata Prefectures to use as a control group. The survey items included birth information, anthropometric measurements, and methods of nutrition during infancy. Results: Eighty municipalities from Iwate, Miyagi, and Fukushima Prefectures and 21 from the control prefectures participated in the survey. As a result, we established three retrospective cohorts consisting of 13,886, 15,474, and 32,202 preschool children. Conclusions: The large datasets acquired for the present survey will provide valuable epidemiological evidence that should shed light on preschool children's physical growth in relation to the disaster.
Palmer, Elizabeth A; Nielsen, Truman; Peirano, Patricia; Nguyen, Anna T; Vo, Alex; Nguyen, Aivan; Jackson, Stephen; Finlayson, Tyler; Sauerwein, Rebecca; Marsh, Katie; Edwards, Issac; Wilmot, Beth; Engle, John; Peterson, John; Maier, Tom; Machida, Curtis A
Genotypic strains of mutans streptococci (MS) may vary in important virulence properties and be differentially affected by specific components of full-mouth caries restorative therapy. The purpose of this pilot study was to identify mutans streptococci strains that predominate following caries restorative therapy. Plaque from 7 children with severe early childhood caries was collected before and following therapy. MS isolates (N=828) were subjected to polymerase chain reaction (PCR) and arbitrarily primed-PCR (AP-PCR) for assignment within MS strains. Determining the longitudinal changes in MS strain distribution over time within each patient required the isolation of larger numbers of isolates per patient, but from fewer patients. Up to 39 genotypic strains of Streptococcus mutans and Streptococcus sobrinus, and 7 genotypic strains of non-MS streptococci were identified by AP-PCR and 16S ribosomal rRNA gene sequencing. The number of MS strains isolated from each patient were 3 to 7 prior to treatment, diminishing to 1 to 2 dominant MS strains in most patients 6 months following therapy. Caries restorative therapy resulted in shifts of specific mutans streptococcus and non-mutans streptococcus strains. The implications are that caries restorative therapy affects the distribution of MS strains, and that well-accepted practices for caries prevention should be more closely examined for efficacy.
Engler-Stringer, Rachel; Schaefer, Joelle; Ridalls, Tracy
The purpose of this study was to examine how pre- and early adolescent (10-14 years old) children from a wide range of neighbourhoods interact with their local food environment (FE), with a focus on the foods and food sources they access and their locations. Children in this age group are developing independence and mobility within (and beyond) their home neighbourhoods but are somewhat geographically bound as they cannot yet drive. This research consists of qualitative interviews with 31 children (15 males, 16 females) aged 10-14 years living in socio-economically diverse neighbourhoods across Saskatoon, SK. A thematic analysis was conducted. Children's descriptions of what constitutes their neighbourhood FE were varied, ranging from a couple of city blocks to several kilometres from home. Children were familiar with the types of establishment that sell food within their perceived neighbourhood. When children purchased their own food they most frequently cited buying snacks such as ice cream, candy and slushes, and the majority of these purchases were made in convenience stores, gas stations and grocery stores. Few children reported frequenting fast-food or other restaurants without adults, and when they did it was usually to buy snacks such as French fries and ice cream rather than meals. Our results highlight the importance of interventions targeted to this age group, in which personal food choices were reported almost exclusively as being energy- but not nutrient-dense snack foods.
Palmer, Elizabeth A.; Nielsen, Truman; Peirano, Patricia; Nguyen, Anna T.; Vo, Alex; Nguyen, Aivan; Jackson, Stephen; Finlayson, Tyler; Sauerwein, Rebecca; Marsh, Katie; Edwards, Issac; Wilmot, Beth; Engle, John; Peterson, John; Maier, Tom; Machida, Curtis A.
Purpose Genotypic strains of mutans streptococci (MS) may vary in important virulence properties, and may be differentially affected by specific components of full-mouth caries restorative therapy. The purpose of this pilot study was to identify MS strains that predominate following caries restorative therapy. Methods Plaque from seven children with severe early childhood caries was collected before and following therapy. MS isolates (N=828) were subjected to polymerase chain reaction (PCR), and arbitrarily primed-PCR (AP-PCR) for assignment within MS strains. Determining the longitudinal changes in MS strain distribution over time within each patient required the isolation of larger numbers of isolates per patient, but from fewer patients. Results Up to 39 genotypic strains of S. mutans and S. sobrinus, and seven genotypic strains of non-MS streptococci were identified by AP-PCR and 16S ribosomal rRNA gene sequencing. The number of MS strains isolated from each patient were 3–7 prior to treatment, diminishing to 1–2 dominant MS strains in most patients 6 months post-therapy. Conclusions Caries restorative therapy resulted in shifts of specific MS and non-MS streptococci strains. The implications are that caries restorative therapy affects the distribution of MS strains, and that well-accepted practices for caries prevention should be more closely examined for efficacy. PMID:22583870
Neiderhiser, Jenae M.; Scaramella, Laura V.; Reiss, David
The Early Growth and Development Study (EGDS) is a prospective adoption design consisting of 360 linked sets of birth parents, adoptive parents, and adopted children followed from 3 months postpartum through child age 7 years and an additional 200 linked sets for whom recruitment is underway. The EGDS brings together the study of genotype–environment correlation and Genotype × Environment (G × E) interaction to inform intervention development by examining mechanisms whereby family processes mediate or moderate the expression of genetic influences. Participants in the EGDS are recruited through domestic adoption agencies located throughout the United States of America. The assessments occur at 6-month intervals until child age 4-½ years and at ages 6 and 7, when the children are in their 1st and 2nd years of formal schooling (kindergarten and first grade). The data collection includes measures of child characteristics, birth and adoptive parent characteristics, adoptive parenting, prenatal exposure to drugs and maternal stress, birth parent and adopted child salivary cortisol reactivity, and DNA from all participants. The preliminary analyses suggest evidence for G×E interaction beginning in infancy. An intervention perspective on future developments in the field of behavioral genetics is described. PMID:20358398
Zeynep Inan, Hatice; Inan, Taskin
Active engagement has become the focus of many early childhood science education curricula and standards. However, active engagement usually emphasizes getting children engaged with science solely through hands-on activities. Active engagement by way of hands, heads, and hearts are kept separate and rarely discussed in terms of getting all to work together, although inquiry-based education and student interest have been accepted as important in science education. The current study is an inquiry-based research. It aims to describe and examine projects and activity stations for preschoolers in a Turkish preschool classroom bringing together the pieces of the puzzle of science education, called here 'Hands-Heads-Hearts-on Science Education'. The study, conducted from a qualitative-interpretivist paradigm, reveals that activity stations and projects create a context for hands-on (active engagement), heads-on (inquiry based or mental-engagement), and hearts-on (interest based) science education. It is found that activity stations and projects, when maintained by appropriate teacher-support, create a playful context in which children can be actively and happily engaged in science-related inquiry.
Schrempft, S.; Jaarsveld, C.H.M. van; Fisher, A.
BACKGROUND: The obesogenic home environment is usually examined via self-report, and objective measures are required. OBJECTIVE: This study explored whether the wearable camera SenseCam can be used to examine the early obesogenic home environment and whether it is useful for validation of
Davis, Mellar P; Temel, Jennifer S; Balboni, Tracy; Glare, Paul
Palliative care has emerged as care that specifically aims to address gaps inherent in disease-centered approaches in order to enhance care quality in serious illness, both for patients and families and for health care systems. Late palliative care for patients with serious illness mitigates benefits to patients, families, and health care systems. Efforts have been made by investigators to define the impact of earlier palliative care interventions on patient, family and health care systems outcomes. We conducted a systematic review of randomized trials of outpatient and home palliative care, two locations where earlier palliative care do occur, to examine the evidence for palliative care benefits. Various terms were used; the search was performed in PubMed. From this search randomized trials were selected from 62 references derive from this search which appeared to be primary studies. Hand searches were done on references. Fifteen randomized control trials of outpatient palliative care and 13 randomized control trials of palliative home care were collected and collated into tables. Seven systematic reviews obtained and outcomes summarized in a table. Advantages to palliative care include improvement in certain symptoms such as depression, improved patient quality of life, reduced aggressive care at the end of life, increased advanced directives, reduced hospital length of stay and hospitalizations, improved caregiver burden and better maintenance of caregiver quality of life and reduction in the medical cost of care as well as patient and family satisfaction. There are randomized trials which demonstrate that symptoms and quality of life are not improved, and resource utilization and costs are not different from "usual" care. Seven systematic reviews of randomized trials came to similar conclusions. Notable methodological issues account for differences in results. Definitions of "early" palliative care vastly differed. There were no descriptions of what was meant
Myrna, Kathern E
This article provides a brief, clinically relevant review of neurologic disorders of the eye. A description of the neuro-ophthalmic examination is provided. Stepwise descriptions of the most common neuro-ophthalmic abnormalities are provided along with common rule outs. Published by Elsevier Inc.
 Difficult refractions especially in the younger age group were referred to a tertiary health facility for further management. All the children had comprehensive ear examination conducted by an Otorhinolaringologist and drugs were administered to those with treatable eye disease. Results. A total of 620 deaf students were ...
Zhang, Xiao-jun; Wang, Ning-li
Basic knowledge and skills are cornerstone of the diagnosis and treatment of neuro-ophthalmology diseases in ophthalmology practice. Due to the interdisciplinary features of neuro-ophthalmology, neuro-anatomy, neuro-physiology related to eyes, neuro-image and neuro-electrodiagnosis, these should be included in the education for the ophthalmologist. Special attention should be paid to training on capability of logically thinking in neuro-ophthalmology. Multiple ways can be used for the education of ophthalmologists and neurologists for the enhancement of basic knowledge and skills of neuro-ophthalmology in China.
Ansari, Rafat R.
The eye is not just a "window to the soul"; it can also be a "window to the human body." The eye is built like a camera. Light which travels from the cornea to the retina traverses through tissues that are representative of nearly every tissue type and fluid type in the human body. Therefore, it is possible to diagnose ocular and systemic diseases through the eye. Quasi-elastic light scattering (QELS) also known as dynamic light scattering (DLS) is a laboratory technique routinely used in the characterization of macromolecular dispersions. QELS instrumentation has now become more compact, sensitive, flexible, and easy to use. These developments have made QELS/DLS an important tool in ophthalmic research where disease can be detected early and noninvasively before the clinical symptoms appear.
Garcia-Martin, Elena; Rodriguez-Mena, Diego; Herrero, Raquel; Almarcegui, Carmen; Dolz, Isabel; Martin, Jesus; Ara, Jose R; Larrosa, Jose M; Polo, Vicente; Fernández, Javier; Pablo, Luis E
To evaluate correlations between longitudinal changes in neuro-ophthalmologic measures and quality of life (QOL) and disability in patients with multiple sclerosis (MS), using optical coherence tomography (OCT), visual evoked potentials (VEP), and visual field examination. Fifty-four patients with relapsing-remitting MS were enrolled in this study and underwent Multiple Sclerosis Quality of Life questionnaire (54 items) (MSQOL-54) and Expanded Disability Status Scale (EDSS) evaluation, as well as complete neuro-ophthalmologic examination including visual field testing and retinal nerve fiber layer (RNFL) measurements using Cirrus and Spectralis OCT and VEP. All patients were re-evaluated at 12, 24, and 36 months. Logistical regression was performed to analyze which measures, if any, could predict QOL. Overall, RNFL thickness results at the baseline evaluation were significantly different from those at 3 years (p ≤ 0.05), but there were no differences in functional measures (visual acuity, contrast sensitivity, color vision, visual field, and VEP). A reduced MSQOL-54 score was associated with an increase in EDSS score and a decrease in both functional and structural parameters. Patients with longer MS duration presented with a lower MSQOL-54 score (reduction in QOL). Patients with progressive axonal loss as seen in RNFL results had a lower QOL and more functional disability.
Elango, Kalavathy Jayapal; Anandkrishnan, Nitin; Suresh, Amritha; Iyer, Subramania K; Ramaiyer, Sundaram Karimassery; Kuriakose, Moni Abraham
Oral cancer is a potentially preventable disease due to its association with well-known risk factors and easy detectability. There is a significant deficiency in the awareness of oral cancer and its risk factors among the public. Raising public awareness could effectively contribute to achieving a significant reduction in the incidence of oral cancer. The objective of this study was to evaluate the effectiveness of mouth self-examination (MSE) in improving the awareness of oral cancer and its risk factors as well as test its feasibility as an oral cancer-screening tool. The study was carried out in a high-risk population of 57,704 from India, of which, 34,766 individuals who have met the eligibility criteria formed the study population. MSE brochures and trained health workers were employed for the purpose of health education and cancer screening. The present study compared their efficacy to detect oral lesions. Subjects with suspicious lesions were referred to the trained oral cancer specialist for confirmation. A questionnaire to assess the awareness of oral cancer and its risk factors was developed and validated. SPSS (v.11.0) was used for data analysis. The program identified 216 cases of potentially malignant lesions as well as three cases of oral cancer. The findings of MSE and health workers showed 72% concordance, while that of health workers and oral cancer specialist showed 100% concordance. MSE had a low sensitivity of 18%, while the specificity was 99.9%. Though the technique identified high-risk lesions such as red patches (66.7%) and non-healing ulcers (42.9%), the detection rate of white patches was low (12.7%). Overall awareness of oral cancer and its risk factors after introduction of MSE program was over 80%; but the compliance to seek treatment was poor (32%). Mouth self-examination may be used as an effective tool to improve the awareness of oral cancer and for the early detection of lesions. Copyright © 2011 Elsevier Ltd. All rights reserved.
Wainer, Allison L.; Hepburn, Susan; McMahon Griffith, Elizabeth
The goal of this review is to advance the discussion regarding meaningful outcomes of early intervention for children with autism spectrum disorder. The rapid growth in the development and evaluation of early intervention approaches for autism spectrum disorder includes both therapist-driven and parent-mediated interventions. The majority of…
Hutchinson, Delyse M.; Rapee, Ronald M.; Taylor, Alan
This study tested five proposed models of the relationship of negative affect and peer factors in early adolescent body dissatisfaction, dieting, and bulimic behaviors. A large community sample of girls in early adolescence was assessed via questionnaire (X[overbar] age = 12.3 years). Structural equation modeling (SEM) indicated that negative…
Silvina De Luca
ón de estudios por imágenes en la evaluación de las principales entidades neuro-oftalmológicas que se presentan con signos y síntomas oculares nos permiten arribar a un diagnóstico temprano y, como consecuencia, a la implementación del tratamiento indicado.Objectives. To report the clinical and etiological correlation of different orbitocranial lesions in patients initially presenting with ophthalmologic symptoms and to determine its contribution to the selection of the diagnostic test of choice for each individual case. Materials and Methods. We have evaluated retrospectively 36 patients with orbital and/or intracranial conditions, who presented at the ophthalmology department of our institution between july 2007 and january 2011. All patients underwent an ophthalmologic examination, computerassisted campimetry, multislice computed tomography (MSCT, magnetic resonance imaging (MRI and some had a histopathological test performed. Results. The most common initial symptom was decreased or impaired visual acuity, present in 22 patients (61%. Others symptoms were diplopia in 9 patients (25%, exophthalmos in 2 (5.5%, orbital hematoma in 2 (5.5% and leukocoria in 1 (3%. In the group of patients with visual impairments, the etiological diagnoses were diverse and included: sphenoid meningioma (n=4, Devic's disease (n=2, brainstem glioma (n=1, optic glioma in the context of type 1 neurofibromatosis (n=1, metastasis of breast carcinoma (n= 4, brain lymphoma (n=2, stroke (n=4, lymphocytic hypophysitis (n=1 and pseudotumor cerebri (n=2. In patients with diplopia diagnosis included: a quadrigeminal plate tumor, one pineal cyst with acute hydrocephalus, two posterior communicating artery aneurysms, two intracavernous internal carotid artery aneurysms (one of them giant and dissecting, one ventral supraclinoid internal carotid artery aneurysm and two fronto-ethmoidal mucoceles. We highlight the presence of two optic nerve meningiomas initially presented with exophthalmos and
Full Text Available The ophthalmic application of nanometer materials are mainly concentrated on controlled releasing systems. Due to the unique properties of nanometer materials,it has great advantages in carrying ophthalmic drugs compared with the conventional method, mainly in higher bioavailability and fewer side effects. As a result, nano-controlled releasing system has good application prospect in ophthalmology. At present, a variety of different types of nano-controlled releasing systems have been used to enhance the efficiency of the ophthalmic drugs, including nanomicelle, nanoparticles, nanosuspensions, liposomes,dendrimers, etc. In this paper, the research progress as well as the application of nano-controlled releasing system on ophthalmologic administration is reviewed.
Full Text Available Drug delivery to the inner part of the eye is still a problem in treatment of ocular disease. Iontophoresis has been used in the field of medicine for many years. This technique consists of applying a weak electrical current to drive charged drug molecules across tissue barriers. Transcorneal iontophoresis delivers a high concentration of drug to the anterior segment of the eye (cornea, aqueous humor, ciliary body, iris, and lens, for the treatment of anterior segment diseases. There are different types of iontophoresis such as ophthalmic, transdermal, transungual, oral, buccal, and transnasal. The benefit of iontophoretic drug delivery in ophthalmology lays in its capacity to provide high drug tissue concentration safely, while minimizing the systemic drug exposure. This review summarizes basics of ocular iontophoresis and iontophoretic device, trans corneal and transscleral iontophoresis, and the applications of iontophoresis in ophthalmology.
Golnik, Karl C; Motley, W Walker; Atilla, Huban; Pilling, Rachel; Reddy, Aravind; Sharma, Pradeep; Yadarola, Maria B; Zhao, Kanxing
To produce an internationally valid tool to assess skill in performing strabismus surgery. A panel of 7 content experts adapted a previously published tool for assessing phacoemulsification by using a modified Dreyfus scale of skill acquisition and providing behavioral descriptors for each level of skill in each category. The tools were then reviewed by 12 international content experts for their constructive comments. The main outcome measure was a consensus of the experts on the final rubric. Experts' comments were incorporated, establishing face and content validity. The tool (Ophthalmology Surgical Competency Assessment Rubric for Strabismus Surgery (ICO-OSCAR: strabismus) has face and content validity. It can be used globally to assess strabismus surgical skill. Reliability and predictive validity are yet to be determined. Copyright © 2012 American Association for Pediatric Ophthalmology and Strabismus. Published by Mosby, Inc. All rights reserved.
Caramoy, Albert; Korwitz, Ulrich; Eppelin, Anita; Kirchhof, Bernd; Fauser, Sascha
To analyze the aggregate impact factor (AIF) in ophthalmology, its inflation rate, and its relation to other subject fields. A retrospective, database review of all subject fields in the Journal Citation Reports (JCR), Science edition. Citation data, AIF, number of journals and citations from the years 2003-2011 were analyzed. Data were retrieved from JCR. Future trends were calculated using a linear regression method. The AIF varies considerably between subjects. It shows also an inflation rate, which varies annually. The AIF inflation rate in ophthalmology was not as high as the background AIF inflation rate. The AIF inflation rate caused the AIF to increase annually. Not considering these variations in the AIF between years and between fields will make the AIF as a bibliometric tool inappropriate. Copyright © 2012 S. Karger AG, Basel.
Du, Hong-jun; Zhang, Kang; Hui, Yan-nian
Although the resource devoted for scientific research increased substantially in recent years, the quality of our basic and clinical study still leaves much to be improved. Besides the shortcomings in administration of research funding, our researchers, as the entity of scientific work, should fully recognize that innovation and application are vital for basic and clinical research in ophthalmology. It is emphasized that the principles and methods in an innovative study, including comprehensive grasp for up-to-date information, proposal of a key project, collaboration of multi-disciplines, through design of a study, and acceleration of application in practice, should be followed in order to make new advances in our cause in ophthalmology.
Joice Elise Androwiki
Full Text Available Purpose: The aim of this study was to evaluate the Eye Retinopathy Trainer® as a teaching tool for direct ophthalmoscopy examination by comparing it with the traditional method using volunteers. Methods: Fourth year medical students received training in direct ophthalmoscopy using a simulation tool and human volunteers. Ninety students were randomized into a Simulation Group or a Control Group by the inclusion or absence of the simulation model in classroom practice. Differences between the groups were analyzed using unpaired Student’s t-test. Results: The Simulation Group was superior to the Control Group, with 51.06% successful in performing fundus examination in both the anatomical model simulation and the human model in comparison with 21.15% in the Control Group. Conclusion: The Eye Retinopathy Trainer® appears to be an effective teaching tool for practice and improvement of ophthalmologic examination among fourth year medical students.
Marrugo, A.; Millán, M. S.; Cristóbal, G.; Gabarda, S.; Šorel, Michal; Šroubek, Filip
Roč. 2012, č. 6 (2012), s. 1-3 ISSN 1818-2259 R&D Projects: GA MŠk 1M0572 Institutional research plan: CEZ:AV0Z10750506 Institutional support: RVO:67985556 Keywords : computer-aided diagnosis * medical and retinal image * deconvolution * telemedicine Subject RIV: JD - Computer Applications, Robotics http://library.utia.cas.cz/separaty/2012/ZOI/sorel-toward computer-assisted diagnosis and telemedicine in ophthalmology .pdf
International relationships in ophthalmology in the former German Democratic Republic (GDR) were directed by the government and predominantly promoted relationships to socialist countries in Eastern Europe. The lack of freedom of travel, restrictions of import for scientific journals and general prevention of contacts by the State security service led to a stagnation in daily practice and in research, mainly from 1961 until 1989.
Dolz-Güerri, F; Gómez-Durán, E L; Martínez-Palmer, A; Castilla Céspedes, M; Arimany-Manso, J
Patient safety is an international public health priority. Ophthalmology scientific societies and organisations have intensified their efforts in this field. As a tool to learn from errors, these efforts have been linked to the management of medical professional liability insurance through the analysis of claims. A review is performed on the improvements in patient safety, as well as professional liability issues in Ophthalmology. There is a high frequency of claims and risk of economic reparation of damage in the event of a claim in Ophthalmology. Special complaints, such as wrong surgery or lack of information, have a high risk of financial compensation and need strong efforts to prevent these potentially avoidable events. Studies focused on pathologies or specific procedures provide information of special interest to sub-specialists. The specialist in Ophthalmology, like any other doctor, is subject to the current legal provisions and appropriate mandatory training in the medical-legal aspects of health care is essential. Professionals must be aware of the fundamental aspects of medical professional liability, as well as specific aspects, such as defensive medicine and clinical safety. The understanding of these medical-legal aspects in the routine clinical practice can help to pave the way towards a satisfactory and safe professional career, and help in increasing patient safety. The aim of this review is to contribute to this training, for the benefit of professionals and patients. Copyright © 2017 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.
Ramesh Venkatesh; Sumit Kumar
Purpose: The aim is to assess the prevalence, severity, and associations of back pain among Indian ophthalmologists. Methods: A self-reporting questionnaire was sent to ophthalmologists with valid e-mail addresses registered with the All India Ophthalmological Society. The survey was open for responses for 2 months. Results: A total of 651 (5.96%) responses were obtained; 394 (61%) males and 257 (39%) females. Half (50%) of responses were obtained from doctors belonging to 31?40 years' age gr...
Miller, Marilyn T; Strömland, Kerstin; Ventura, Liana; Johansson, Maria; Bandim, Jose M; Gillberg, Christopher
ABSTRACT Purpose To review the association of autism spectrum disorder (ASD) in individuals manifesting thalidomide embryopathy and Möbius sequence and compare them with three new studies in which ASD was also associated with ocular and systemic malformations: (1) a Swedish study of individuals with CHARGE association (Coloboma, Heart, choanal Atresia, developmental or growth Retardation, Genital anomaly, and Ear involvement); (2) a Swedish study of Goldenhar syndrome; and (3) Brazilian Möbius syndrome (sequence) study. Methods In the Swedish CHARGE study, 31 patients met the inclusion criteria (3+ or 4 of the common characteristics of the CHARGE syndrome). The same team of investigators also evaluated 20 Swedish patients with Goldenhar syndrome. In the Brazilian Möbius study, 28 children with a diagnosis of Möbius sequence were studied; some children had a history of exposure during their mother’s pregnancy to the abortifacient drug misoprostol in an unsuccessful abortion attempt Results In the CHARGE study, five patients had the more severe autism disorder and five had autistic-like condition. In the Goldenhar study, two had autism disorder and one had autistic-like condition. In the Brazilian Möbius study, the systemic findings of the misoprostol-exposed and misoprostol-unexposed patients were almost undistinguishable, and ASD was present in both groups (autism disorder in five and autistic-like condition in three). Conclusion Autism spectrum disorder has been reported in two conditions with known early pregnancy exposure to the teratogenic agents thalidomide and misoprostol. In the Brazilian Möbius study, autism also occurred in both the misoprostol-exposed and misoprostol-unexposed groups. Autism also was present in patients with both CHARGE association and Goldenhar syndrome. PMID:15747750
Shiu Ting Mak
Full Text Available Purpose. To arouse ophthalmologists’ awareness in patient safety by reviewing sentinel events in Ophthalmology submitted to a web-based incident reporting system involving all public hospitals in Hong Kong. Methods. Sentinel events in Ophthalmology reported from November 2007 to October 2014 were identified and classified into different categories for further presentation and analysis. Key contributing factors attributing to the occurrence of the incidents were described. Suggestions aiming to prevent future occurrence of similar events were made. Relevant literature and case law were discussed. Results. Twelve sentinel events were included in this observational case series. They were classified into 4 main categories, namely “wrong eye” (5 cases, 41%, “wrong prescription” (3 cases, 25%, “wrong patient and surgery” (2 cases, 17%, and “retained surgical items” (2 cases, 17%. The key contributing factor leading to the occurrence of the incidents was largely human error. Increased staff awareness and proper time-out procedures were recommended to help prevent occurrence of these errors. Conclusion. Sentinel events in Ophthalmology do occur. Many of these incidents were attributed to human error. Surgeon’s awareness and willingness to prevent occurrence of sentinel events are warranted.
Frohman, Larry P
Neuro-ophthalmology is facing a serious human resource issue. Few are entering the subspecialty, which is perceived as being poorly compensated compared with other subspecialties of ophthalmology. The low compensation comes from the fact that 1) non-procedural encounters remain undervalued, 2) efforts that benefit other medical specialists are not counted, and 3) the relatively low expenses of neuro-ophthalmologists are not factored into compensation formulas. Mission-based budgeting, which forces academic departments to be financially accountable without the expectation of fiscal relief from medical schools or practice plans, has exacerbated the compensation issue. Solutions must come from within neuro-ophthalmology, academic departments, medical schools, and medical practice plans. They include 1) providing educational resources so that neuro-ophthalmologists need not spend so much time teaching the basics, 2) factoring into compensation the impact of neuro-ophthalmologists in teaching and on revenue generation by procedure-based specialists, 3) improving the efficiency of neuro-ophthalmologists in their consultative practices by providing ample clerical support and other measures, 4) providing contractual salary compensation by departments such as neurosurgery to recognize the contributions made by neuro-ophthalmologists, and 5) reorganizing the academic clinical effort as multidisciplinary rather than departmental.
Full Text Available Abstract Ophthalmologists and researchers in ophthalmology understand what a rapidly evolving field ophthalmology is, and that to conduct good research it is essential to use the latest and best methods. In outcomes research, one modern initiative has been to conduct holistic measurement of outcomes inclusive of the patient's point of view; patient-centred outcome. This, of course, means including a questionnaire. However, the irony of trying to improve outcomes research by being inclusive of many measures is that the researcher may not be expert in all measures used. Certainly, few people conducting outcomes research in ophthalmology would claim to be questionnaire experts. Most tend to be experts in their ophthalmic subspecialty and probably simply choose a popular questionnaire that appears to fit their needs and think little more about it. Perhaps, unlike our own field, we assume that the field of questionnaire research is relatively stable. This is far from the case. The measurement of patient-centred outcomes with questionnaires is a rapidly evolving field. Indeed, over the last few years a paradigm shift has occurred in patient-centred measurement.
Tsegaw, Asegedech; Tsegaw, Asamere; Abula, Tefera; Assefa, Yared
Ophthalmic solutions used for both diagnostic and therapeutic purposes were found to be contaminated with bacteria pathogens and caused serious ocular infections such as keratitis and endophthalmitis. The objective was to assess the magnitude and pattern of bacterial contamination of multi-dose ophthalmic medications and investigate the drug susceptibility pattern of the isolates in the Department of Ophthalmology at Gondar University Teaching Hospital. A total of 100 ophthalmic medications in-use by patients and eye-care workers have been taken and cultured for potential bacterial contamination in the Microbiology Department after 1 week and >1 week of use. The dropper tip and the residual eye medications were examined for contamination. The contaminating bacteria were identified using a standard procedure and drug susceptibility testing to selected antimicrobial agents was done. Eleven ophthalmic medications were contaminated by different bacterial species with a prevalence of 11%. Multi-use and longer duration of use of eye medications were associated with higher rate of contamination. The contamination level ranges from 0% for antibiotics, 20% for local anesthetics, and 40% for povidone iodine. Among bacteria identified, Staphylococcus aureus and coagulase-negative Staphylococcus species were resistant to methicillin while others were sensitive to the antibiotics tested. The prevalence of contamination was low, but methicillin-resistant Staphylococcus was a potential risk. It is recommended that the Department of Ophthalmology should design set of rules about duration of use and safe handling of ophthalmic medications by the staff and patients.
Sharkins, Kimberly A.; Leger, Sarah E.; Ernest, James M.
Early childhood poverty is a prevalent social issue, both in the United States and in the wider international community. It has been well established that factors associated with poverty, including familial income and parental education level, can negatively affect children's language and cognitive development, which can result in academic…
Mitsch, Christoph; Bolz, Matthias; Sacu, Stefan; Vass, Clemens; Scholda, Christoph; Huber, Patrick; Sabutsch, Stefan; Schmidt-Erfurth, Ursula
Significant improvements in the field of diagnostic methods and therapeutic options achieved during the last decade allow the early diagnosis, accurate follow-up and individual indication for the treatment with highly efficacious therapeutic agents in a wide range of ophthalmological pathologies. The burden on health care systems is extremely high, as treatment and diagnostic follow up has to be repeated in a regular manner. Whereas the treatment can only be applied in tertiary care centers (eye clinics), follow-up and management mainly depends on the OCT technology, which is becoming available at many field ophthalmologists' practices. This article describes the OphthalNet project, a network which optimizes collaboration between eye clinics and field ophthalmologists based on medical guidelines, workflow support and the future use of electronic infrastructure.
Schargus, M; Michelson, G; Grehn, F
Electronic storage of patient-related data will replace paper-based patient records in the near future. Because of the high visualization needed in ophthalmology integrated electronic data storage and usage will be very useful. Chronic diseases like glaucoma, macular degeneration and diabetic retinopathy would benefit from long-term data storage and analysis. Unfortunately there are nearly no widely accepted systems available providing these options. Another important point is the simplification of existing diagnostic procedures and nomenclature on an international level. Increasing mobility of patients requires a better portability of existing medical examination data between different physicians. This is the only way to provide continuously high levels of quality in patient care and to simultaneously reduce costs and prevent unnecessary secondary examinations.
Nilsen, Wendy; Gustavson, Kristin; Røysamb, Espen; Kjeldsen, Anne; Karevold, Evalill
The main aim of this study was to identify the pathways from maternal distress and child problem behaviors (i.e., internalizing and externalizing problems) across childhood and their impact on depressive symptoms during adolescence among girls and boys. Data from families of 921 Norwegian children in a 15-year longitudinal community sample were used. Using structural equation modeling, the authors explored the interplay between maternal-reported distress and child problem behaviors measured at 5 time points from early (ages 1.5, 2.5, and 4.5 years) and middle (age 8.5 years) childhood to early adolescence (age 12.5 years), and their prediction of self-reported depressive symptoms during adolescence (ages 14.5 and 16.5 years). The findings revealed paths from internalizing and externalizing problems throughout the development for corresponding problems (homotypic paths) and paths from early externalizing to subsequent internalizing problems (heterotypic paths). The findings suggest 2 pathways linking maternal-rated risk factors to self-reported adolescent depressive symptoms. There was a direct path from early externalizing problems to depressive symptoms. There was an indirect path from early maternal distress going through child problem behavior to depressive symptoms. In general, girls and boys were similar, but some gender-specific effects appeared. Problem behaviors in middle childhood had heterotypic paths to subsequent problems only for girls. The findings highlight the developmental importance of child externalizing problems, as well as the impact of maternal distress as early as age 1.5 years for the development of adolescent depressive symptoms. Findings also indicate a certain vulnerable period in middle childhood for girls. NOTE: See Supplemental Digital Content 1, at http://links.lww.com/JDBP/A45, for a video introduction to this article.
Abela, John R. Z.; Hankin, Benjamin L.; Sheshko, Dana M.; Fishman, Michael B.; Stolow, Darren
The current study tested the stress-reactivity extension of response styles theory of depression (Nolen-Hoeksema "Journal of Abnormal Psychology" 100:569-582, 1991) in a sample of high-risk children and early adolescents from a vulnerability-stress perspective using a multi-wave longitudinal design. In addition, we examined whether obtained…
Miller, Marilyn T.; Strömland, Kerstin K.
Purpose of review The thalidomide tragedy of the early 1960s resulted in a great number of studies and reports involving many specialties of medicine. Because of the estimated large number of affected children (5000+) worldwide exposed to this potent teratogen, and the many informative cases in which the exposure time was known, a teratogenic timetable was constructed relating affected structures to the time of exposure. This demonstrated that thalidomide had a teratogenic effect between approximately 20 to 36 days after fertilization. Recent findings We found that Duane syndrome and its variants were prominent in individuals who were exposed to thalidomide early in the sensitive period (days 20 to 26±). Other anomalies associated with this early effect were aberrant tearing, facial nerve palsy, ear malformations, and autism. Structural eye malformations were less frequent in this early phase, appearing slightly later in the sensitive period. Summary This study summarizes the ophthalmologic findings from a number of studies and compares them with respect to the implications of time of exposure. Because the timing of anomalies such as external ear and limb malformations are well established in the thalidomide literature, correlation with associated eye anomalies gives insight into the approximate timing of the causative teratogen exposure. PMID:21825994
Stone, L.L.; Otten, R.; Janssens, J.M.A.M.; Soenens, B.; Kuntsche, E.N.; Engels, R.C.M.E.
Parental psychological control has been linked to symptoms of psychopathology in adolescence, yet less is known about its correlates in childhood. The current study is among the first to address whether psychological control is related to internalizing and externalizing problems in early childhood.
Stone, Lisanne L.; Otten, Roy; Janssens, Jan M. A. M.; Soenens, Bart; Kuntsche, Emmanuel; Engels, Rutger C. M. E.
Parental psychological control has been linked to symptoms of psychopathology in adolescence, yet less is known about its correlates in childhood. The current study is among the first to address whether psychological control is related to internalizing and externalizing problems in early childhood. A community sample of 298 children aged 7.04…
Multilevel modeling was used to investigate the relationship between poverty status, mathematics achievement gains, and behavioral engagement in learning over kindergarten. Data included information on 11,680 poor, low-income, and non-poor kindergartners from the Early Childhood Longitudinal Study-Kindergarten Cohort of 1998-1999 (ECLS-K). Results…
Puranik, Cynthia S.; Patchan, Melissa M.; Lemons, Christopher J.; Al Otaiba, Stephanie
Despite the poor outcomes for U.S. students on national writing tests, overall research on how to teach writing is sparse, and this scarcity is more pronounced in the early years of beginning to write. In this study 81,200 we present preliminary findings from Year 1 of a 3-year Institute of Education Sciences-funded Goal 2 project aimed at…
Tejwani, Sushma; Murthy, Somasheila I; Gadudadri, Chandra Sekhar; Thomas, Ravi; Nirmalan, Praveen
A cohort study was performed to assess the impact of an intensive, hands-on, supervised training program in ophthalmic clinical evaluation, for ophthalmology residents and private practitioners. All students underwent one-month training in comprehensive ophthalmology examination and investigations at a tertiary care center between January 2004 and January 2006. The training methodology included didactic lectures, video-demonstrations and hands-on training. The participants completed a self-assessment with a set of 23 questions designed to assess the level of confidence in various skills on the first and last day of the training. Of a total of 118 students, 67 (56.8%) were residents and 51 (43.2%) were practitioners. The mean score pre-training was 38.3 out of 92 (S.D. ±16.9), and was 70.6 out of 92 (S.D.± 10.1) post-training. The mean increase in the scores was 32.3 (P value ophthalmology residents and practitioners. PMID:20534932
Full Text Available Abstract Neuro-Behçet’s disease (NBD involves the central nervous system; peripheral nervous system involvement is not often reported. NBD is quite common in adult patients and occurs rarely during childhood and adolescence. Young patients may share symptoms and signs of NBD with other neuro-ophthalmological disorders (e.g. idiopathic intracranial hypertension; thus, making the differential diagnosis difficult. Neuroimaging is mandatory and necessary for a correct NBD diagnosis but in children radiological examinations are often difficult to perform without sedation. From 1971 to 2011, 130 patients aged ≤16 years have been reported with NBD, according to retrospective surveys, case series, and case reports. The origin of the reported cases met the well-known geographical distribution of Behçet’s disease (BD; the mean age at presentation of neurological findings was 11.8 years, with male gender prevalence (ratio, 2.9:1. We considered in detail the neuro-ophthalmological features of the 53 cases whose neuroimaging alterations were described with an assigned radiological pattern of the disease (parenchymal: 14 cases, non-parechymal: 35 cases, and mixed: 4 cases. In 19/53 patients (36%, neuro-ophthalmological symptoms anticipated any pathognomonic sign for a BD diagnosis, or only occasional aphtae were recalled by the patients. Family history was positive in 17% of subjects. Headache was reported in 75% of the patients; in those presenting with cerebral vascular involvement, headache was combined to other symptoms of intracranial hypertension. Papilledema was the most frequently reported ophthalmological finding, followed by posterior uveitis. Treatment consisted of systemic steroids in 93% of patients, often combined with other immunosuppressive drugs (especially colchicine and azathioprine. Clinical recovery or improvement was documented in the large majority of patients. Nine subjects had definitive alterations, and one died. Based on our
Layat, I; Challe, G; LeHoang, P; Bodaghi, B; Touitou, V
Neuro-ophthalmologic conditions require specialized multidisciplinary management, both medical and surgical, for patients affected by visual loss due to nervous system disease. The primary goal of this study is to define the specificity of neuro-ophthalmology within the realm of visual health. The secondary goal is to review clinical care pathways by studying the organization of management, in terms of accessibility to care and personalization of the care pathway. A field study was carried out from February to June 2015, within the ophthalmology service of the Pitié-Salpêtrière University Medical Center in Paris. A 30-minute interview with the patient before or after his or her neuro-ophthalmology consultation was performed, so as to describe the clinical care pathway. The medical records of interviewed patients were also analyzed. Seventeen care pathways (10 women and 7 men) were reviewed. The mean age at appearance of visual involvement was 44.5 years (±8.4 years). If we exclude 3 patients over 66 years and retired, 35.71% were active, 35.71% were disabled, and 28.57% were on sick leave. Ten patients (58.82%) met the criteria for admission to long-term care. The first step had been carried out by local private practitioners. The first physician seen was the general medicine physician (59%), then the private ophthalmologist on an emergency basis (17%). On average, patients went through 8 steps during their care pathway (from 6 to 10 steps) and 14 medical departments were involved. The study showed collaboration with the other services of the University Hospital Department of Vision and Disabilities (notably with the Fondation Rothschild, the Quinze-Vingts National Ophthalmology Hospital and the Fondation Sainte-Marie). In addition to rehabilitation services, health care professionals participating in the outpatient care of the patients included an orthoptist (11.7%), a psychologist (11.7%), and an optician specializing in low vision for visual aids
Nargiso, Jessica E.; Friend, Karen; Florin, Paul
This study examines the relationship between peer, family, and community context risk factors and alcohol use; gender is examined as a potential moderator of these relationships. Hierarchical logistic regressions conducted in a sample of 781 seventh grade students found that normative beliefs about peers' alcohol use emerged as the most consistent…
Leffler, Christopher T; Davenport, Byrd; Chan, Dana
To use internet search activity to reveal the intensity of public interest and seasonal variation in ophthalmology-related diseases, symptoms, and treatments. Time-series analysis of internet search data. Google trend data for ophthalmology terms for the United States, the United Kingdom, Canada, and Australia from 2004 through 2008 were studied. Mean population-weighted temperature and fraction of schools in session were estimated from databases, and relative potential sunlight intensity was calculated. Multivariable linear regression was used to predict search term frequency based on environmental variables. Relative to diabetes searches (100%), common US eye-related searches were: "glasses" (44%), "Lasik" (16%), "contact lenses" (12.4%), "pink eye" (9.5%), "glaucoma" (5.9%), "cataract" (4.1%), "dry eyes" (2.1%), "eye twitching" (1.9%), and "eye pain" (1.9%). Seasonal nature was high for "conjunctivitis" (r(2) = 0.37), "pink eye" (r(2) = 0.32), "eye floaters" (r2 = 0.26), and "stye" (r(2) = 0.19), moderate for "glaucoma" (r(2) = 0.09) and "eye twitching" (r(2) = 0.06), and low for "uveitis" (r(2) = 0.02) and "macular degeneration" (r(2) pink eye," "conjunctivitis," and "glaucoma" (all p eyes" and "eye floaters" (p eye twitching" (p >= 0.001) and negatively with "eyeglasses." "Eye allergy," "itchy eyes," and "watery eyes" were highly seasonal (r(2) = 0.75-0.38) and associated with "pollen" searches. Internet ophthalmology searches relate (in decreasing order) to refractive correction, eye diseases, and eye symptoms. Search study reveals the seasonality and environmental associations of interest in health terms.
John, Ann M; John, Elizabeth S; Hansberry, David R; Thomas, Prashant J; Guo, Suqin
Patients increasingly consult online resources for healthcare information. The American Medical Association (AMA) and National Institutes of Health (NIH) recommend that online education resources be written between a 3rd- and 7th-grade level. This study assesses whether online health information abides by these guidelines. Ten pediatric ophthalmology conditions were entered into a commonly used search engine, Google.com, and analyzed using 10 validated readability scales. Scientific articles and articles written on patient forums were excluded. The 10 conditions--amblyopia, cataract, conjunctivitis, corneal abrasion, nystagmus, retinoblastoma, retinopathy of prematurity, strabismus, stye, and glaucoma--were also searched and analyzed separately from widely used websites, including Wikipedia and WebMD, as well as those of professional societies, including the American Association for Pediatric Ophthalmology and Strabismus (AAPOS) and the American Optometric Association (AOA). The majority of articles were written above recommended guidelines. All scales showed that the 100 articles were written at a mean grade-level of 11.75 ± 2.72. Only 12% of articles were written below a 9th-grade level and only 3% met recommended criteria. The articles accrued separately from Wikipedia, WebMD, AAPOS, and AOA also had average grade levels above the recommended guidelines. The readability of online patient education material exceeds NIH and AMA guidelines. This disparity can adversely affect caregiver comprehension of such resources and contribute to poor decision making. Pediatric ophthalmology online articles are generally written at a level too high for average caregiver comprehension. Revision of articles can increase satisfaction, improve outcomes, and facilitate the patient-ophthalmologist relationship. Published by Elsevier Inc.
Mimouni, Michael; Krauthammer, Mark; Gershoni, Assaf; Mimouni, Francis; Nesher, Ronit
Previous studies in several fields of medicine have reported an association between the result of a trial (positive versus negative) and the impact factor of the journal in which it is published. The purpose of this study was to test the hypotheses that in the field of ophthalmology: (1) studies with positive results have a greater chance of being published in journals with a higher impact factor; (2) likewise, studies with a larger number of participants are more likely to be published in journals with a higher impact factor. In this retrospective study, consecutive randomized, controlled trials conducted in the field of ophthalmology between 1 January 2010 and 1 January 2013 were retrieved from PubMed. Each study was classified as having either a positive or negative result. A positive result was defined as a study in which there was a statistically significant difference between groups (p impact factor of the journal in which the study was published was retrieved. The number of patients enrolled and whether or not the trial was placebo controlled was documented as well. Out of 2524 studies identified, 892 met the inclusion criteria. Studies with positive results were published in journals with a significantly higher impact factor than that of the journals in which negative result studies were published (p impact factor was significantly predicted by the primary outcome (positive versus negative results) and the number of participants in a study (total R(2 )= 2.95, p impact factor. This finding supports the ongoing occurrence of positive results bias in the field of ophthalmology.
Oza, Karishma K.; Silverman, Jay G.; Bojorquez, Ietza; Strathdee, Steffanie A.; Goldenberg, Shira M.
Objective To explore experiences during childhood and adolescence that influenced reproductive and sexual health among women who had entered the sex industry in adolescence. Methods A qualitative study was conducted using information provided by 25 female sex workers (FSWs) from Tijuana, Mexico, who reported entering the sex industry when younger than 18 years. In-depth, semi-structured interviews were conducted with all participants between January 31, 2011, and July 8, 2011. Results Four interrelated themes that shaped health experiences—early sexual abuse, early illicit drug use, ongoing violence, and limited access to reproductive and sexual health care—were identified. Participants reporting these experiences were at risk of unintended teenaged pregnancy, spontaneous abortion or stillbirth, and untreated sexually transmitted infections. Conclusion Programs and policies that address social, structural, and individual vulnerabilities during adolescence and adulthood are required to promote reproductive and sexual health among FSWs in Tijuana, Mexico. PMID:25458416
Adare, A. M.; McCumber, M. P.; Nagle, J. L.; Romatschke, P.
The redistribution in momentum space of heavy quarks via their interactions in the quark-gluon plasma is an excellent probe of the heavy quark coupling strength to the medium. We utilize a Monte Carlo Langevin calculation for tracking heavy quark-antiquark pairs embedded in a viscous hydrodynamic space-time evolution. We find that the nuclear modification factor (RAA) for charm quarks is relatively insensitive to the coupling to the quark-gluon plasma at early times where the highest temperatures are achieved. In contrast the azimuthal angular correlation of charm and anticharm quarks is extremely sensitive to the early time evolution. For beauty quarks the situation is reversed in terms of sensitivity. This work identifies the kinematic distributions of the heavy quarks with the greatest sensitivity, and must be followed by tests of whether they survive hadronization, in particular if recombination is dominant.
Ioan Emanuel STAVARACHE
Full Text Available The aim of the present work was to characterize the surface properties of (polymethylmethacrylate (PMMA foils used in ophathalmological applications. Thus, the morphology, chemical composition and surface energy of these PMMA foils are analyzed, by specific measurements, at the interface with different test liquids of interest in ophthalmology, i.e. distilled H2 O, physiological serum and ophthalmic solution of ReNu Multiplus, used for contact lens cleaning, hydration and disinfection. Also, a solution of Nostamine, known as a drug used in eye irritation and conjunctival inflammation, was tested.
Coster, Douglas J
The purpose of this report is to document the contribution of two New Zealanders, Barrie Jones and Rowland Wilson, to the development of modern ophthalmology. Their related contribution was made over a period of 80 years; it began in Egypt with Wilson, developed when they worked together in Dunedin and where they created the foundations for the brilliant career that Jones was to go on to in London. Their story emphasizes the impact of teaching and mentorship. It highlights the extended reach of teaching and the power of continuity in research.
Screening for diabetic retinopathy (DR) not only allows for detection of microvascular complications, but for detection of other comorbidities. Recent advances in digital camera technology have improved screening for DR and many countries have established systems that screen all diabetics for DR annually. However, South Africa has lagged behind due to pressures at the primary care level, with the result that many diabetics are not screened. In response, the Ophthalmology Society of Southern Africa has developed a low-cost 'scorecard' system for a national DR screening programme.
Tamai, Mami; Kawakami, Atsushi; Iwamoto, Naoki; Kawashiri, Shin-Ya; Fujikawa, Keita; Aramaki, Toshiyuki; Kita, Junko; Okada, Akitomo; Koga, Tomohiro; Arima, Kazuhiko; Kamachi, Makoto; Yamasaki, Satoshi; Nakamura, Hideki; Ida, Hiroaki; Origuchi, Tomoki; Takao, Shoichiro; Aoyagi, Kiyoshi; Uetani, Masataka; Eguchi, Katsumi
To verify whether magnetic resonance imaging (MRI)-proven joint injury is sensitive as compared with joint injury determined by physical examination. MRI of the wrist and finger joints of both hands was examined in 51 early-stage rheumatoid arthritis (RA) patients by both plain and gadolinium diethylenetriaminepentaacetic acid-enhanced MRI. Synovitis, bone edema, and bone erosion (the latter two included as bone lesions at the wrist joints); metacarpophalangeal joints; and proximal interphalangeal joints were considered as MRI-proven joint injury. Japan College of Rheumatology-certified rheumatologists had given a physical examination just before the MRI study. The presence of tender and/or swollen joints in the same fields as MRI was considered as joint injury on physical examination. The association of MRI-proven joint injury with physical examination-proven joint injury was examined. A total of 1,110 sites were available to be examined. MRI-proven joint injury was found in 521 sites, whereas the other 589 sites were normal. Physical examination-proven joint injury was found in 305 sites, which was significantly low as compared with MRI-proven joint injury (P = 1.1 × 10(-12) versus MRI). Joint injury on physical examination was not found in 81.5% of the sites where MRI findings were normal. Furthermore, an association of the severity of MRI-proven joint injury with that of joint injury on physical examination was clearly demonstrated (P = 1.6 × 10(-15), r(s) = 0.469). Our present data suggest that MRI is not only sensitive but accurately reflects the joint injury in patients with early-stage RA. Copyright © 2011 by the American College of Rheumatology.
Hedges, Thomas R
Bernard Schwartz, MD, PhD (1927-2007) was first and foremost a scholar. He was a teacher, serving as Professor of ophthalmology for many years at Tufts University; an administrator, chairing the department of ophthalmology for over 20 years; a clinician, practicing primarily in the field of glaucoma; a scientist with a broad interest in ophthalmic research; an historian, especially of medical history; and an editor, primarily of Survey of Ophthalmology. Throughout all of his activities, the central theme was always scholarship.
Chao, Daniel L.; Schiffman, Joyce C.; Gedde, Steven J.
Objective To analyze ophthalmologists who are National Institutes of Health (NIH) K grant awardees to characterize clinician-scientists in ophthalmology. Design Cohort study. Participants Ophthalmologists who have received a K award from 1996 to 2010. Methods K08 and K23 grant awardees were identified through the NIH Research Portfolio Online Reporter database. Information including gender, institution, educational degrees, and success in obtaining an R01 grant was analyzed. Main Outcome Measure Receipt of an R01 grant. Results One hundred five ophthalmologists were identified who received K08 or K23 grants from the National Eye Institute from 1996 to 2010. Overall, 75% of these were male, although 43% of K awardees were women from 2006 to 2010. Sixty five percent (68/105) of individuals came from ophthalmology departments that ranked in the top 20 of NIH funding in 2010. The most predominant subspecialties represented were retina (32%), cornea (22%), and glaucoma (15%). Among the K awardees, 40% (42/105) had a Doctor of Philosophy (PhD) degree in addition to their Medical Doctor (MD) degree. From 1996 to 2000, 61% (23/38) individuals were successful in obtaining an R01 grant, while only 13% (5/39) individuals from 2001 to 2005 have obtained R01 grants (pophthalmology, but these seem to be improving over time. None of the other variables studied: gender, PhD degree, specialty, or funding tier was associated with obtaining R01 funding. This study helps to characterize the clinician-scientist cohort in ophthalmology and identify areas to improve the recruitment of these individuals. PMID:23631948
Gürkan, Zeren; Christensen, Asbjørn; Deurs, Mikael van
concentrations is regarded important for survival. Intense aggregations of zooplankton in near-surface waters provide these conditions for larval fish. Simulation studies by individual-based modeling can help understanding of the mechanisms for survival during early life-stages. In this study, we examined how...... growth and survival of larvae and early juveniles of Lesser Sandeel (Ammodytes marinus) in the North Sea are influenced by availability and patchiness of the planktonic prey by adapting and applying a generic bioenergetic individual-based model for larval fish. Input food conditions were generated...... by modeling copepod size spectra dynamics and patchiness based on particle count transects and Continuous Plankton Recorder time series data. The study analyzes the effects of larval hatching time, presence of zooplankton patchiness and within patch abundance on growth and survival of sandeel early life...
Chung, Cheuk Wang; Girard, Michaël J. A.; Jan, Ning-Jiun; Sigal, Ian A.
Purpose Laplace's Law, with its compactness and simplicity, has long been employed in ophthalmology for describing the mechanics of the corneoscleral shell. We questioned the appropriateness of Laplace's Law for computing wall stress in the eye considering the advances in knowledge of ocular biomechanics. Methods In this manuscript we recapitulate the formulation of Laplace's Law, as well as common interpretations and uses in ophthalmology. Using numerical modeling, we study how Laplace's Law cannot account for important characteristics of the eye, such as variations in globe shape and size or tissue thickness, anisotropy, viscoelasticity, or that the eye is a living, dynamic organ. Results We show that accounting for various geometrical and material factors, excluded from Laplace's Law, can alter estimates of corneoscleral wall stress as much as 456% and, therefore, that Laplace's Law is unreliable. Conclusions We conclude by illustrating how computational techniques, such as finite element modeling, can account for the factors mentioned above, and are thus more suitable tools to provide quantitative characterization of corneoscleral biomechanics. PMID:26803799
Lee, Andrew G.; Chen, Ying
There has been a shift in graduate medical education (GME) from the traditional “apprenticeship” model to a more curriculum-based and competency driven model. Reflecting a global trend towards residency education reform, the International Council of Ophthalmology (ICO) introduced a resident and specialist curriculum and several live educational programs to promote standardization and more effective GME and continuing professional training. Implementation of these educational innovations will require efforts by local educator champions; modification and customization of teaching and assessing tools to the local learning environment; alignment of the implementation blueprint with available resources; and creation of accountability and sustainability mechanisms to insure long-term viability of the educational reforms. An ultimate goal of the ICO curriculum is to allow real world testing and modification so that the ideas generated in one part of the world might be applicable and generalizable in other areas. We aim to describe the Accreditation Council of Graduate Medical Education (ACGME) competencies in the United States (US) and ICO curriculum, as well as to provide a step-by-step plan for implementation of an ophthalmology residency curriculum. PMID:24791099
Pathipati, Akhilesh S; Tsai, James C
As American health care evolves, an increasing number of doctors are pursuing MBAs. However, relatively little is known about how business training translates into their future careers. This study characterizes ophthalmologists who have completed MBAs and identifies opportunities for physician leadership in the field. Cross-sectional study METHODS: We identified 120 ophthalmologists who hold MBAs. We searched each individual's online profiles to collect information on demographics, training, and professional activities. Physician-MBAs in ophthalmology are 80% male. 80% are fellowship trained. 28% are in primarily non-clinical roles and 55% participate in significant non-clinical activity. Hospital administration is most common (31%), followed by pharmaceutical administration (7%), and consulting (5%). Older ophthalmologist-MBAs were more likely to work in non-clinical roles, with 79% of those who completed residency before 2000 engaged in significant non-clinical activity compared to 30% of those who completed residency after 2000. The most common employers of physician-MBAs in ophthalmology are academic medical centers (43%), large group practices (30%), and private practices (13%). The majority of ophthalmologist-MBAs work in primarily clinical roles although a sizable proportion hold non-clinical positions. Moving forward, we anticipate an increased role for physician leaders in health care administration, policy, and entrepreneurship. While formal management training is not necessary for these roles, a growing number of physicians have sought out MBAs to support their non-clinical interests. Copyright © 2018 Elsevier Inc. All rights reserved.
Grzybowski, Andrzej; Kanclerz, Piotr; Myers, William G
Povidone-iodine (PVI) is a disinfectant and antiseptic agent used for preoperative preparation of the skin and mucous membranes, as well as for the treatment of contaminated wounds. Currently regimens for prophylaxis against postsurgical endophthalmitis are being modified, including a total withdrawal of antibiotics in intravitreal injections. The aim of this study was to evaluate the use of PVI in ophthalmology. As a result of its broad spectrum of microbicidal activity, PVI is routinely used in ophthalmic surgery. However, various protocols are applied worldwide and within different procedures. Additional indications include prophylaxis against ophthalmia neonatorum, acute conjunctivitis, adenoviral conjunctivitis, bacterial keratitis or corneal ulcer, endophthalmitis, giant fornix syndrome, and antimicrobial prophylaxis in patients with Boston type I keratoprosthesis. Despite the introduction of new antiseptics in surgery, PVI is still the preeminent antiseptic measure in ophthalmology. Its use is economically reasonable. There have been no reports of resistance to PVI or anaphylaxis with topical ophthalmic use. Furthermore, it does not induce resistance or cross-grztance to antibiotics. With these advantages the range of indications for topical use of antibiotics might decrease, with PVI as the sole perioperative antiseptic measure. Additional studies are required to assess the optimal timing, concentration and exposure time within different ophthalmic procedures.
Radfar, Edalat; Park, Jihoon; Lee, Sangyeob; Ha, Myungjin; Yu, Sungkon; Jang, Seulki; Jung, Byungjo
A stereoscopic imaging modality was developed for the application of ophthalmology surgical microscopes. A previous study has already introduced a single-channel stereoscopic video imaging modality based on a transparent rotating deflector (SSVIM-TRD), in which two different view angles, image disparity, are generated by imaging through a transparent rotating deflector (TRD) mounted on a stepping motor and is placed in a lens system. In this case, the image disparity is a function of the refractive index and the rotation angle of TRD. Real-time single-channel stereoscopic ophthalmology microscope (SSOM) based on the TRD is improved by real-time controlling and programming, imaging speed, and illumination method. Image quality assessments were performed to investigate images quality and stability during the TRD operation. Results presented little significant difference in image quality in terms of stability of structural similarity (SSIM). A subjective analysis was performed with 15 blinded observers to evaluate the depth perception improvement and presented significant improvement in the depth perception capability. Along with all evaluation results, preliminary results of rabbit eye imaging presented that the SSOM could be utilized as an ophthalmic operating microscopes to overcome some of the limitations of conventional ones.
Maudgil, A; Salvi, S M; Tan, J H Y; Mudhar, H S
The purpose of this study was to improve communication between the ophthalmology and histopathology departments at Royal Hallamshire Hospital, Sheffield, by effectively changing the structure and completion of the histopathology request form through the process of a successful audit. This aimed to ensure that comprehensive information was made available to the histopathologist. An audit was performed by review of 710 histopathology request forms, completed by the ophthalmology department, over a 1-year period, between July 2005 and June 2006 inclusive. Results were used to re-model the ophthalmic histopathology request form. New forms were circulated and all forms completed over a 3-month period, between January 2008 and March 2008, were reviewed, thus closing the audit loop. On the basis of audit results of 710 histopathology request forms, a new histopathology request form was created, which was easier to complete. Review of the 224 new histopathology request forms showed improved percentages of completion of important sections of the form. Through the audit process we have created a new ophthalmic histopathology request form that is more user-friendly for the ophthalmologist and more consistently provides the necessary information for the ophthalmic histopathologist. This has improved efficiency and effectiveness of communication between the specialities, which should contribute to minimise the chances of medical error and improved turnaround times for the planning and delivery of patient care.
Cohen, Ali R; Renner, Lynette M; Shriver, Erin M
Intimate partner violence (IPV) is a leading cause of death and disability worldwide. Despite increasing public awareness of IPV, little information is available regarding the prevalence, associated injury patterns, and impact of IPV as a mechanism of ocular and orbital trauma. The purpose of this review is to summarize the literature regarding the impact of IPV in ophthalmology and provide team members with guidance on appropriate practices for screening and referral. Data from 48 population-based studies estimates that the lifetime prevalence of IPV ranges from 10 to 69% among women internationally. Head, neck, or facial trauma is 7.5 times more likely in female patients presenting to the emergency department than female patients with other injury patterns. Forty-five percent of injuries acquired from IPV involve the eyes. IPV is the third leading cause of orbital fractures and traumatic ocular injuries from IPV tend to be severe in nature with a large percent of women sustaining scleral rupture. The high prevalence of IPV as a mechanism of orbital and ocular injury demands training all members of the ophthalmology team in identifying IPV, providing support, and making appropriate referrals to improve patient safety and well-being.
Oza, Karishma K; Silverman, Jay G; Bojorquez, Ietza; Strathdee, Steffanie A; Goldenberg, Shira M
To explore experiences during childhood and adolescence that influenced reproductive and sexual health among women who had entered the sex industry in adolescence. A qualitative study was conducted using information provided by 25 female sex workers (FSWs) from Tijuana, Mexico, who reported entering the sex industry when younger than 18 years. In-depth, semi-structured interviews were conducted with all participants between January 31, 2011, and July 8, 2011. Four interrelated themes that shaped health experiences-early sexual abuse, early illicit drug use, ongoing violence, and limited access to reproductive and sexual health care-were identified. Participants reporting these experiences were at risk of unintended teenaged pregnancy, spontaneous abortion or stillbirth, and untreated sexually transmitted infections. Programs and policies that address social, structural, and individual vulnerabilities during adolescence and adulthood are required to promote reproductive and sexual health among FSWs in Tijuana, Mexico. Copyright © 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.
Diratzouian, Hasmik; Freedman, Gary M; Hanlon, Alexandra L; Eisenberg, Debra F; Anderson, Penny R
A recent trial called into question the efficacy of breast self-examination. We studied the characteristics and outcome of women in whom physical examination (PE) was their sole method of breast cancer detection. From 1970 to 1998, 1752 women with stage I/II breast cancer underwent breast-conserving surgery and radiation. Two hundred sixty patients (15%) had abnormal PE finding as their sole method of cancer detection at the time of diagnosis, 723 (41%) had only mammographic findings, and 762 (43%) had both. Detection by PE was associated with younger age, larger tumor size, positive axillary nodes, and use of chemotherapy. For women Physical examination remains an important method of detection of breast cancer, particularly for younger women for whom mammography is less sensitive and not performed as frequently.
Lonigan, Christopher J.; Allan, Darcey M.; Phillips, Beth M.
There is strong evidence that self-regulatory processes are linked to early academic skills both concurrently and longitudinally. The majority of extant longitudinal studies, however, have been conducted using autoregressive techniques that may not accurately model change across time. The purpose of this study was to examine the unique associations between two components of self-regulation, attention and executive functioning (EF), and growth in early literacy skills over the preschool year using latent-growth-curve analysis. The sample included 1,082 preschool children (M-age = 55.0 months, SD = 3.73). Children completed measures of vocabulary, syntax, phonological awareness, print knowledge, cognitive ability, and self-regulation, and children’s classroom teachers completed a behavior rating measure. To examine the independent relations of the self-regulatory skills and cognitive ability with children’s initial early literacy skills and growth across the preschool year, growth models in which the intercept and slope were simultaneously regressed on each of the predictor variables were examined. Because of the significant relation between intercept and slope for most outcomes, slope was regressed on intercept in the models to allow a determination of direct and indirect effects of the predictors on growth in children’s language and literacy skills across the preschool year. In general, both teacher-rated inattention and directly measured EF were uniquely associated with initial skills level; however, only teacher-rated inattention uniquely predicted growth in early literacy skills. These findings suggest that teacher-ratings of inattention may measure an aspect of self-regulation that is particularly associated with the acquisition of academic skills in early childhood. PMID:27854463
Worton, S Kathleen; Hasford, Julian; Macnaughton, Eric; Nelson, Geoffrey; MacLeod, Timothy; Tsemberis, Sam; Stergiopoulos, Vicky; Goering, Paula; Aubry, Tim; Distasio, Jino; Richter, Tim
We present interim findings of a cross-site case study of an initiative to expand Housing First (HF) in Canada through training and technical assistance (TTA). HF is an evidence-based practice designed to end chronic homelessness for consumers of mental health services. We draw upon concepts from implementation science and systems change theory to examine how early implementation occurs within a system. Case studies examining HF early implementation were conducted in six Canadian communities receiving HF TTA. The primary data are field notes gathered over 1.5 years and evaluations from site-specific training events (k = 5, n = 302) and regional network training events (k = 4, n = 276). We report findings related to: (a) the facilitators of and barriers to early implementation, (b) the influence of TTA on early implementation, and (c) the "levers" used to facilitate broader systems change. Systems change theory enabled us to understand how various "levers" created opportunities for change within the communities, including establishing system boundaries, understanding how systems components can function as causes of or solutions to a problem, and assessing and changing systems interactions. We conclude by arguing that systems theory adds value to existing implementation science frameworks and can be helpful in future research on the implementation of evidence-based practices such as HF which is a complex community intervention. Implications for community psychology are discussed. © Society for Community Research and Action 2017.
This study is aimed to gain insights into adolescents' classroom peer climate by examining descriptive and status norms of academic and social behaviors. Descriptive norm was assessed as the average score for each behavior and status norm was assessed using the correlation between each behavior and social status within each classroom. Expanded…
King, Elizabeth; La Paro, Karen
Research Findings: This study examined 34 Head Start teachers' use of four categories of mental state talk (verbalizations of mental processes using emotion terms, cognition terms, desire terms, and perception terms) during naturally occurring classroom interactions. Transcriptions from classroom videos were coded for mental state talk…
Gallagher, Michelle; Prinstein, Mitchell J.; Simon, Valerie; Spirito, Anthony
Recent research has shown that social anxiety may be related to increased risk for suicidal ideation in teens, although this research largely has been cross-sectional and has not examined potential mediators of this relationship. A clinical sample of 144 early adolescents (72 % female; 12?15 years old) was assessed during psychiatric inpatient hospitalization and followed up at 9 and 18 months post-baseline. Symptoms of social anxiety, depression, suicidal ideation, loneliness, and perceived ...
Full Text Available The study included 125 cows with reduced appetite and with clinical signs interpreted by the owner as indicating bovine ketosis 6 to 75 days postpartum. Almost all of the cows were given concentrates 2 to 3 times daily. With a practitioners view to treatment and prophylaxis the cows were divided into 5 diagnostic groups on the basis of thorough clinical examination, milk ketotest, decreased protozoal activity and concentrations, increased methylene blue reduction time, and increased liver parameters: ketosis (n = 32, indigestion (n = 26, combined ketosis and indigestion (n = 29, liver disease combined with ketosis, indigestion, or both (n = 15, and no specific diagnosis (n = 17. Three cows with traumatic reticuloperitonitis and 3 with abomasal displacement were not grouped. Nonparametric methods were used when groups were compared. Aspartate aminotransferase, glutamate dehydrogenase, gamma-glutamyl transferase and total bilirubin were elevated in the group with liver disease. Free fatty acids were significantly elevated in cows with ketosis, compared with cows with indigestion. Activity and concentrations of large and small protozoas were reduced, and methylene blue reduction time was increased in cows with indigestion. The rumen fluid pH was the same for groups of cows with and without indigestion. Prolonged reduced appetite before examination could have led to misclassification. Without careful interpretation of the milk ketotest, many cases with additional diagnoses would have been reported as primary ketosis. Thorough clinical examination together with feasible rumen fluid examination and economically reasonable blood biochemistry did not uncover the reason(s for reduced appetite in 14% of the cows. More powerful diagnostic methods are needed.
Lee, Andrew G.; Greenlee, Emily; Oetting, Thomas A.; Beaver, Hilary A.; Johnson, A. Tim; Boldt, H. Culver; Abramoff, Michael; Olson, Richard; Carter, Keith
Purpose To describe an ophthalmology wet laboratory (OWL) curriculum for residents in training. Methods Systematic literature review and selection of best practices for use in the OWL learning plan from a single academic ophthalmology program. Results A pretest and posttest of cognitive
Hill, Sophie; Dennick, Reg; Amoaku, Winfried
To investigate the current undergraduate ophthalmology curricula provided by the UK medical schools, evaluate how they compare with the guidelines of the Royal College of Ophthalmologists (RCOphth) and International Council for Ophthalmology (ICO), and determine the views of the UK ophthalmology teaching leads on the future direction of the curriculum. A cross-sectional questionnaire was sent to teaching leads in 31 medical schools across the UK. The questionnaire evaluated eight themes of the curriculum: content and learning outcomes, communication of learning outcomes, organisation of the curriculum, assessment, educational resources, teaching methods used, and the educational environment. The ophthalmology teaching leads were also asked their opinion on the current and future management of the curriculum. These were compared with RCOphth and ICO guidelines and descriptive statistical analysis performed. A response rate of 93% (n=29/31) was achieved. The knowledge and clinical skills taught by the UK medical schools match the RCOphth guidelines, but fail to meet the ICO recommendations. A diverse range of assessment methods are used by UK medical schools during ophthalmology rotations. Variation was also observed in the organisation and methods of ophthalmology teaching. However, a significant consensus about the future direction of the curriculum was reported by teaching leads. Comprehensive RCOphth guidance, and resource sharing between medical schools could help to ensure ophthalmology's continuing presence in the medical curriculum and improve the effectiveness of undergraduate ophthalmology teaching, while reducing the workload of local teaching departments and medical schools.
De Kegel, Alexandra; Maes, Leen; Van Waelvelde, Hilde; Dhooge, Ingeborg
As deaf children are now implanted at a very early age, the influence of a cochlear implant (CI) on the early motor development of children with a hearing loss becomes relevant. Forty-eight children with a hearing loss were included in this controlled prospective follow-up study and were subdivided into a CI group (n = 23) receiving a CI during the follow-up period and a control group (n = 25) receiving no CI during the follow-up period. All children were assessed around the ages of 6 (T1), 12 (T2), 18 (T3), and 24 (T4) months with a motor test battery consisting of the Peabody Developmental Motor Scales-2 (PDMS-2), Alberta Infant Motor Scales (AIMS) (only at T1 and T2), and Ghent Developmental Balance Test (GDBT) (only at T3 and T4). In addition, collic vestibular-evoked myogenic potential testing was performed in all children. Group differences in PDMS-2 Gross Motor Quotient (GMQ), Fine Motor Quotient, AIMS z score, and GDBT z score were analyzed using Linear Mixed Model (LMM) analysis for repeated measures. For PDMS-2 GMQ, the LMM revealed significant effects for group (p = 0.04), test moment (p < 0.001), and for the interaction between these two factors (p = 0.035). Contrasts indicated that the CI group showed a greater deterioration in PDMS-2 GMQ between T2 and T3 compared with that showed by the control group (p = 0.002). The LMM for PDMS-2 Fine Motor Quotient and AIMS z score showed no significant effects. For GDBT z score, the LMM pointed out significant effects for group (p = 0.013) and test moment (p < 0.001), but no significant interaction between these two factors. Contrasts indicated that the CI group performed significantly weaker than the control group at both test moments (T3 and T4; all p < 0.012) and that both groups showed a significant recovery in GDBTz scores between T3 and T4 (all p < 0.012). This study shows that the trajectory of gross motor development can be changed in children with a hearing loss after a cochlear implantation. Implanted
Gueglio, G; Bergero, M; Treiyer, S; Cristallo, C; Isola, M; Damia, O
The presence of tumor cells in the spermatic cord was evaluated in patients undergoing inguinal testis study in order to assure if the placement of a clamp in it was necessary to avoid tumor dissemination. Inguinal testis studies were performed over a two year period in 38 patients diagnosed of testicular mass. The presence of tumor cells in blood vessels or lymph nodes of the cord was evaluated in all of the patients. Testicular tumors were found in 28 patients (20 seminoma, 5 mixed tumor and 3 embryonal) with an average age of 42 (range 21-82) years. There were T1N0M0 21; T1N1M0 3; T2N0M0 2 and T2N1M0 2 cases, respectively. Independently of the stage and tumor lineage, tumor cells in the cord vessels were not observed in any of the cases through the pathology study. In our causistics, it seems that the surgical act consisting in the placement of a clamp early in the cord lacks a scientific foundation. However, this study does not make it possible to state that not performing this maneuver during the surgical procedure is oncologically safe. Thus, a precedent is established to perform studies with a larger number of patients that will make it possible to corroborate this observation. This would result in less traumatic and safer surgical techniques that would allow conserving the testis and its functionality. Copyright © 2011 AEU. Published by Elsevier Espana. All rights reserved.
Dawson, William J
Performing arts medicine (PAM) emerged as a medical specialty around 1985. Prior to this time, relatively few publications addressed the identification and concerns of musicians' and dancers' medical problems. To determine what number and types of publications occurred prior to the actual beginnings of PAM as a discipline, and to determine how these original topics compared with present-day publications, a retrospective review of the current bibliographic database of the Performing Arts Medicine Association (PAMA) was undertaken. Out of a total of 12,600 entries to date, 489 references were found published from 1798 through 1974, which represent only 3.9% of the current database listings. One-sixth of the references were originally written in a language other than English. Journal articles were by far the most numerous type of publication. Topics with the highest number of entries included the neurobiology of music (n=77), dental/orofacial matters (71), and biographical accounts of composers or musicians and their illnesses (59). Other frequently published topics included hearing loss, physiology of playing instruments, and instrumental technique and teaching. Early topics with multiple publications included composers' biographies, dystonias, and surgery to improve finger independence for playing piano. Subjects whose publications occurred principally in the last two decades of this review included dermatological disorders, hearing loss, and ballet physiology, teaching, and technique. Those which remain popular to the present day include hearing loss, performance anxiety, focal dystonia, and dental/orofacial problems.
Sheridan, Susan M; Knoche, Lisa L; Kupzyk, Kevin A; Edwards, Carolyn Pope; Marvin, Christine A
Language and literacy skills established during early childhood are critical for later school success. Parental engagement with children has been linked to a number of adaptive characteristics in preschoolers including language and literacy development, and family-school collaboration is an important contributor to school readiness. This study reports the results of a randomized trial of a parent engagement intervention designed to facilitate school readiness among disadvantaged preschool children, with a particular focus on language and literacy development. Participants included 217 children, 211 parents, and 29 Head Start teachers in 21 schools. Statistically significant differences in favor of the treatment group were observed between treatment and control participants in the rate of change over 2 academic years on teacher reports of children's language use (d=1.11), reading (d=1.25), and writing skills (d=0.93). Significant intervention effects on children's direct measures of expressive language were identified for a subgroup of cases where there were concerns about a child's development upon entry into preschool. Additionally, other child and family moderators revealed specific variables that influenced the treatment's effects. Copyright © 2011 Society for the Study of School Psychology. Published by Elsevier Ltd. All rights reserved.
Bouwes, Aline; Binnekade, Jan M; Verbaan, Bart W; Zandbergen, Eveline G J; Koelman, Johannes H T M; Weinstein, Henry C; Hijdra, Albert; Horn, Janneke
Bilateral absence of cortical N20 responses of median nerve somatosensory evoked potentials (SEP) predicts poor neurological outcome in postanoxic coma after cardiopulmonary resuscitation (CPR). Although SEP is easy to perform and available in most hospitals, it is worthwhile to know how neurological signs are associated with SEP results. The aim of this study was to investigate whether specific clinical neurological signs are associated with either an absent or a present median nerve SEP in patients after CPR. Data from the previously published multicenter prospective cohort study PROPAC (prognosis in postanoxic coma, 2000-2003) were used. Neurological examination, consisting of Glasgow Coma Score (GCS) and brain stem reflexes, and SEP were performed 24, 48, and 72 h after CPR. Positive predictive values for predicting absent and present SEP, as well as diagnostic accuracy were calculated. Data of 407 patients were included. Of the 781 SEPs performed, N20 s were present in 401, bilaterally absent in 299, and 81 SEPs were technically undeterminable. The highest positive predictive values (0.63-0.91) for an absent SEP were found for absent pupillary light responses. The highest positive predictive values (0.71-0.83) for a present SEP were found for motor scores of withdrawal to painful stimuli or better. Multivariate analyses showed a fair diagnostic accuracy (0.78) for neurological examination in predicting an absent or present SEP at 48 or 72 h after CPR. This study shows that neurological examination cannot reliably predict absent or present cortical N20 responses in median nerve SEPs in patients after CPR.
Full Text Available Introduction: Prolactinomas are less frequent, but more invasive in males. Giant ones (≥4 cm are extremely rare in literature. Their neurological, psychiatric and endocrine complications are life threatening. Our aim was to report the largest mono center series in order to analyze their frequency, their characteristics, and their complications. Subjects and Methods: All patients had clinical examination, hormonal, ophthalmological, and radiological assessment based on computed tomography scan and cerebral magnetic resonance imaging. Positive diagnosis was based on clinical symptoms, high prolactin ± immunohistochemy study. Mixed adenomas were excluded by hormonal exploration and immunohistochemy. For those who received medical treatment only, a reduction in tumor size was considered a supplementary positive point for the diagnosis. Results: Among 154 male prolactinomas seen between 1987 and 2013, we observed 44 giant tumors (28.5%. Median age = 36 years, and 38.3% were under 30. Median tumor height = 53.95 mm (40-130 and median prolactin = 15,715 ng/ml (n < 20. Solid and cystic aspect ± calcifications was observed in 25%. 42 had cavernous sinuses invasion. Other invasions were: Posterior= 65.9%, anterior= 63.6%, temporal= 15.9% and frontal = 9%. For endocrine complications: Hypogonadism = 98.4%, thyrotroph and corticotroph deficits were seen in respectively 34%, and 32%. Posterior pituitary insufficiency was observed in one case. For ophthalmological complications: Optic atrophy = 46%, Ptosis = 6.8%, diplopia/strabismus = 4.5%. Neurological complications were: Memory loss and/or unconsciousness = 18.2%, epilepsy = 15.9%, frontal syndrome = 9% and obstructive hydrocephalus = 6.8%. Conclusion: Giant prolactinomas account for 28% in our population. Severe neurological complications are frequent. But, obstructive hydrocephalus is rare, which argues for a slow progression.
Berk, Sarah; Greco, Brittany L; Biglan, Kevin; Kopil, Catherine M; Holloway, Robert G; Meunier, Claire; Simuni, Tanya
Challenges in clinical trial recruitment threaten the successful development of improved therapies. This is particularly true in Parkinson's disease (PD) studies of disease modification where the population of interest is difficult to find and study design is more complex. This paper seeks to understand how STEADY PD III, a National Institute of Neurological Disorders and Stroke (NINDS) funded phase 3 trial evaluating the efficacy of isradipine as a disease modifying agent for PD, was able to recruit their full target population 6 months ahead of schedule. STEADY PD III aimed to enroll 336 individuals with early stage idiopathic PD within 18 months using 57 sites across the United States and Canada. The study included a 10% NIH minority recruitment goal. Eligible participants agreed to be followed for up to 36 months, complete 12 in-person visits and 4 telephone visits. A Recruitment Committee of key stakeholders was critical in the development of a comprehensive recruitment strategy involving: multi-modal outreach, protocol modifications and comprehensive site selection and activation. Efforts to increase site-specific minority recruitment strategies were encouraged through additional funding. A total of 336 individuals, including 34 minorities, were enrolled within 12 months - 6 months ahead of the projected timeline. Quantitative analysis of recruitment activity questionnaires found that of the sites that completed them (n = 54), (20.4%) met goals, (24.1%) exceeded goals, and (55.6%) fell below projected goals. Referral sources completed at time of screening indicate top four study referral sources as: site personnel (53.8%); neurologists (24%); Fox Trial Finder (10.2%); and communications from The Michael J. Fox Foundation (3.9%). STEADY PD III serves as an important example of methods that can be used to increase clinical trial recruitment. This research highlights a continued need to improve site infrastructure and dedicate more resources to increased
Full Text Available Jonathan A Micieli,1 Edmund Tsui2 1Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada; 2Department of Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA Background: The use of social media in ophthalmology remains largely unknown. Our aim was to evaluate the extent and involvement of ophthalmology journals, professional associations, trade publications, and patient advocacy and fundraising groups on social networking sites. Methods: An archived list of 107 ophthalmology journals from SCImago, trade publications, professional ophthalmology associations, and patient advocacy organizations were searched for their presence on Facebook, Twitter, and LinkedIn. Activity and popularity of each account was quantified by using the number of “likes” on Facebook, the number of followers on Twitter, and members on LinkedIn. Results: Of the 107 journals ranked by SCImago, 21.5% were present on Facebook and 18.7% were present on Twitter. Journal of Community Eye Health was the most popular on Facebook and JAMA Ophthalmology was most popular on Twitter. Among the 133 members of the International Council of Ophthalmology, 17.3% were present on Facebook, 12.8% were present on Twitter, and 7.5% were present on LinkedIn. The most popular on Facebook was the International Council of Ophthalmology, and the American Academy of Ophthalmology was most popular on Twitter and LinkedIn. Patient advocacy organizations were more popular on all sites compared with journals, professional association, and trade publications. Among the top ten most popular pages in each category, patient advocacy groups were most active followed by trade publications, professional associations, and journals. Conclusion: Patient advocacy groups lead the way in social networking followed by professional organizations and journals. Although some journals use social media, most have yet to engage its full potential and maximize the number of
Yamamura, J; Wildberger, J E; Nagel, H-D; Dichtl, D; Adam, G; Wedegärtner, U
The purpose of this study was to optimize high-resolution MSCT chest protocols for the evaluation of symptomatic immunosuppressed patients with suspected pneumonia using a dose-simulating program. Using the MSCT (Siemens, Erlangen, Germany), 30 immunosuppressed patients with suspected pneumonia were examined with a low-dose HRCT of the chest (120 kV, 100 eff.mAs and collimation of 4 x 1 mm). A dose-simulating program was used to reconstruct the raw data at four different dose levels (70, 50, 35 und 25 mAs). For dose simulation for each mAs product, the correspondent noise level was added to the data. Images were generated with a slice thickness of 1 mm and 5 mm in the lung window. The images were then evaluated independently by two radiologists and graded on a scale of 1 to 3 points: 1 = no pneumonia, 2 = unclear, 3 = pneumonia. A receiver operating curve (ROC) analysis was performed to calculate the area under the curve (AUC). The actual dosage in mSv was calculated. The sensitivity and specificity were evaluated. Out of 30 patients, 7 had a normal chest finding and 23 had pneumonia. The area under the ROC curve (AUC) was 1.0 for every dosage and slice thickness. Infiltrates were detected correctly for all dosage levels. The sensitivity was 100 % for all dose levels and slice thicknesses. There was one false positive finding at 35 mAs and 1 mm slice thickness. At this dose level the specificity was reduced to 93 %. A reduction to 25 mAs had no influence on the detection of pneumonia. Thus, MSCT examinations of the chest can be performed with 25 mAs without missing the right diagnosis, resulting in an effective dose of 1.15 mSv (men), 1.5 mSv (women) and a CTDIvol of 2.5 mGy. For the evaluation of pneumonia in immunocompromised patients, MSCT examination of the chest can be performed with 25 mAs. Thus, radiation exposure was reduced to a quarter compared to the standard protocol.
M Jabbarvand Behrouz
Full Text Available "nThe response of living tissues to the surgical trauma is associated with varying degrees of tissue repair and involves two distinct processes including replacement and regeneration. Replacement results in scar tissue formation instead of restoration of the normal architecture. However, regeneration leads to restoration of the original architecture leaving no sign of injury. Anti-proliferative agents are used to inhibit tissue responses to surgical trauma. Among them mitomycin- C and 5- FU had gained increasing applications in ophthalmic surgeries, including filtering glaucoma surgeries, laser vision correction with excimer laser by ablative surface refractive surgery, reconstructive surgeries for ocular surface disorders and removal of neoplastic tissues and secondary operations on nasolacrimal ducts. In this review article, the various aspects of applications of these agents including their mechanism of action, function, mode of application and complications in different ophthalmology fields are discussed.
Full Text Available The method of laser correlation spectroscopy (LCS is based on the analysis of the spectrum of quasielastic light scatter during coherent monochromatic laser irradiation of micro-particles in biological fluids (blood serum, urine, oropharyngeal washout fluid, tear fluid etc.. Spectrum provides information on dynamic processes in the analyzed system: translation motion of scattering particles and their orientation and conformation dynamics. Special procedures of cluster analysis make it possible to find out to which linkage group a particular spectrum belongs. LCS allows evaluation of sub-fractional composition of biological fluids in a wide range of molecular sizes (from 1 to 10,000 nm, which determines principal novelty of this approach in ophthalmology.
Full Text Available Allison Rizzuti,1,2 Adam Goldenberg,1 Douglas R Lazzaro1,2 1SUNY Downstate Medical Center, 2Kings County Hospital Center, Brooklyn, NY, USA Abstract: Amniotic membrane, the innermost layer of the placenta, is a tissue that promotes epithelialization, while decreasing inflammation, neovascularization, and scarring. It is used in the surgical management of a wide variety of ophthalmic conditions where it functions as a graft or patch in ocular surface reconstruction. The development of new preservation techniques, as well as a sutureless amniotic membrane, has allowed for easier, in-office placement, without the disadvantages of an operating room procedure. The purpose of this review is to describe the historical development of amniotic membrane in ophthalmology and to describe its current clinical applications, particularly focusing on recent advances. Keywords: ocular surface, cornea, stem cells, prokera, allograft, patch, transplantation
Nazarali, Samir; Mathura, Pamela; Harris, Karen; Damji, Karim F
To develop a standardized process for reviewing daily patient lists and identifying potential risks of misidentification. Our goal was to develop a proactive approach to identify and eliminate risks of patient misidentification. Assessment of current patient identification practices took place over a period of 4 weeks. Using a process map, a patient survey was developed to determine the encounter points when patient identification was confirmed. This information was used to develop a standardized protocol for review of daily appointment lists. Review of daily appointment lists was completed to identify potential similar/same name risks. A standardized manual process of chart review, flagging, and tracking was developed. The name alert process resulted in a simple manual process for identifying which patients have a higher name risk and allowed care providers to take preventative action to decrease potential risk of incorrect diagnostic testing, procedure, or medication administration. Copyright © 2017 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.
Chacón-Camacho, Óscar Francisco; Astorga-Carballo, Aline; Zenteno, Juan Carlos
Gene therapy is a promising new therapeutic strategy that could provide a novel and more effective way of targeting hereditary ophthalmological diseases. The eye is easily accessible, highly compartmentalized, and an immune-privileged organ that gives advantages as an ideal gene therapy target. Recently, important advances in the availability of various intraocular vector delivery routes and viral vectors that are able to efficiently transduce specific ocular cell types have been described. Gene therapy has advanced in some retinal inherited dystrophies; in this way, preliminary success is now being reported for the treatment of Leber congenital amaurosis (LCA). This review will provide an update in the field of gene therapy for the treatment of ocular inherited diseases.
Greenley, Rachel Neff; Taylor, H Gerry; Drotar, Dennis; Minich, Nori M
To examine longitudinal relations between early adolescent family conflict and late adolescent psychosocial adjustment, and the moderating role of low birth weight. Three groups of adolescents (48 with birth weight parents completed ratings of family conflict at age 11 (Time 1). Parent, teacher, and youth reports of psychosocial functioning were obtained at ages 11 and 17 (Time 2). Birth weight moderated the relationship between Time 1 adolescent-perceived conflict and change in adolescent behavioral functioning. For adolescents with histories of conflict predicted less adaptive changes in teacher-reported total behavior problems and externalizing problems. Small disruptions to the parent-child relationship have negative implications for the later well-being of adolescents with extreme levels of low birth weight. Clinical attention to resolving early adolescent conflict may promote adaptive adjustment.
Robinson, Sandy W; Brantley, Kelly; Liow, Christine; Teagarden, J Russell
Patients with rare diseases often face significant health care access challenges, particularly since the number of available treatment options for rare diseases is limited. The implementation of health insurance exchanges promises improved access to health care. However, when purchasing a plan, patients with rare diseases need to consider multiple factors, such as insurance premium, access to providers, coverage of a specific medication or treatment, tier placement of drug, and out-of-pocket costs. To provide an early snapshot of the exchange plan landscape from the perspective of patients with select rare diseases by evaluating the degree of access to medications in a subset of exchange plans based on coverage, tier placement, associated cost sharing, and utilization management (UM) applied. The selection of drugs for this analysis began by identifying rare diseases with FDA-approved treatment options using the National Institutes of Health Office of Rare Diseases' webpage and further identification of a subset of drugs based on select criteria to ensure a varied sample, including the characteristics and prevalence of the condition. The medications were categorized based on whether alternative therapies have FDA approval for the same indication and whether there are comparators based on class or therapeutic area. The list was narrowed to 11 medications across 7 diseases, and the analysis was based on how these drugs are listed in exchange plan outpatient pharmacy benefit formularies. This analysis focused on 84 plans in 15 states with the highest expected exchange enrollment and included a variety of plan types to ensure that variability in the marketplace was represented. To best approximate plans that will have the greatest enrollment, the analysis focused on silver and bronze plan formularies because consumers in this market are expected to be sensitive to premiums. Data on drug coverage, tier placement, cost, and UM were collected from these plans
Vannier-Nitenberg, Christiane; Dauphinot, Virginie; Bongue, Bienvenu; Sass, Catherine; Rouch, Isabelle; Beauchet, Olivier; Krolak-Salmon, Pierre; Fantino, Bruno
Only half of those living with Alzheimer's disease in France are currently diagnosed, and only one patient in three is supported during the early stages of dementia. This study aims to evaluate three cognitive tests for their predictive ability to diagnose mild cognitive impairments and Alzheimer's disease and related disorders. For people aged 65 years or over, presenting with a memory complaint, these tests can be performed easily during a preventative consultation. The EVATEM (évaluation des troubles de l'équilibre et de la mémoire (evaluation of balance and memory problems)) cohort study was designed to prospectively assess the predictive value of tests for the diagnosis of mild cognitive impairments and Alzheimer's disease in elderly subjects aged 65 years or over. Subjects were recruited from three health examination centers that are part of the French health insurance system. If a memory complaint was identified (using a dedicated questionnaire), the five-word test, the cognitive disorders examination test and the verbal fluency test were administered during a preventative consultation. A memory consultation was performed at a University Hospital to diagnosis any potential cognitive disorder and a one-year follow-up consultation was also scheduled. We recorded 2041 cases of memory complaint at our Health Examination Centers. Cognitive tests were refused by 33.6% of people who had a memory complaint. The number of subjects sent to a University Hospital memory consultation was 832 and 74.5% of them completed this consultation. The study population therefore includes 620 subjects. Tests for the early diagnosis of a mild cognitive impairment or Alzheimer's disease and related disorders should be used in centers dedicated to disease prevention. These should guide subjects with memory impairment to full memory consultations at hospitals and improve the access to early medical and behavioral support. ClinicalTrials.gov:NCT01316562.
Yu, Zheng-Lu; Hu, Xin-Yue; Wang, Ying-Na; Ma, Zheng
To investigate the published papers of ophthalmology in past ten years and explore the development of ophthalmology. The data of this study retrieved from Science Citation Index Expanded and downloaded online in November 2017, including all the papers with publication year from 2007-2016 were analyzed. The papers were based on the Web of Science category and the journals were based on the Journal Citation Report category. The number of ophthalmology papers increased from 7450 to 9089 during 2007 to 2017. The average rate increased 2.2% annually. USA accounts for one thirds of the total and two thirds of the highly cited papers. In Asia, China, Japan and South Korea were in Top 10 by the number of ophthalmology papers. UK, Germany, Japan and Australia also had great impact in global ophthalmology. The hot spots included endothelial growth factor, optical coherence tomography and open-angle glaucoma. USA is in the leading position in global ophthalmology. Part of Asian countries play an important role in the development of ophthalmology, but the impact needs to be improved.
Peissig, Peggy; Schwei, Kelsey M; Kadolph, Christopher; Finamore, Joseph; Cancel, Efrain; McCarty, Catherine A; Okorie, Asha; Thomas, Kate L; Allen Pacheco, Jennifer; Pathak, Jyotishman; Ellis, Stephen B; Denny, Joshua C; Rasmussen, Luke V; Tromp, Gerard; Williams, Marc S; Vrabec, Tamara R; Brilliant, Murray H
The capture and integration of structured ophthalmologic data into electronic health records (EHRs) has historically been a challenge. However, the importance of this activity for patient care and research is critical. The purpose of this study was to develop a prototype of a context-driven dynamic extensible markup language (XML) ophthalmologic data capture application for research and clinical care that could be easily integrated into an EHR system. Stakeholders in the medical, research, and informatics fields were interviewed and surveyed to determine data and system requirements for ophthalmologic data capture. On the basis of these requirements, an ophthalmology data capture application was developed to collect and store discrete data elements with important graphical information. The context-driven data entry application supports several features, including ink-over drawing capability for documenting eye abnormalities, context-based Web controls that guide data entry based on preestablished dependencies, and an adaptable database or XML schema that stores Web form specifications and allows for immediate changes in form layout or content. The application utilizes Web services to enable data integration with a variety of EHRs for retrieval and storage of patient data. This paper describes the development process used to create a context-driven dynamic XML data capture application for optometry and ophthalmology. The list of ophthalmologic data elements identified as important for care and research can be used as a baseline list for future ophthalmologic data collection activities.
Ghane, Mohammad Reza; Gharib, Mohammadhadi; Ebrahimi, Ali; Saeedi, Morteza; Akbari-Kamrani, Marjan; Rezaee, Maryam; Rasouli, Hamidreza
Rapid Ultrasound in Shock (RUSH) is a recently reported emergency ultrasound protocol designed to help clinicians better recognize distinctive shock etiologies in a short time. We tried to evaluate the accuracy of early RUSH protocol performed by emergency physicians to predict the shock type in critically ill patients. Our prospective study was approved by the ethics committee of trauma research center, Baqiyatallah University of Medical Science, Iran. We enrolled 52 patients with shock state in the emergency department from April 2013 to October 2013. We performed early bed-side sonographic examination for participants based on RUSH protocol. Patients received all needed standard therapeutic and diagnostic interventions without delay and were followed to document their final diagnosis. Agreement (Kappa index) of initial impression provided by RUSH with final diagnosis, and also sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of RUSH for diagnosis of each shock type were calculated. Fifty-two patients were enrolled in our study. Kappa index was 0.7 (P value = 0.000), reflecting acceptable general agreement between initial impression and final diagnosis. For hypovolemic and obstructive shocks, the protocol had sensitivity of 100% but had lower PPV. For shocks with distributive or mixed etiology, RUSH showed PPV of 100% but had low sensitivity. For cardiogenic shocks, all reliability indices were above 90%. We highlight the role of RUSH examination in the hands of an emergency physician in making a rapid diagnosis of shock etiology, especially in ruling out obstructive, cardiogenic, and hypovolemic types.
Ryan, Allison M; Shim, S Serena; Lampkins-Uthando, Shawn A; Thompson, Geneene N; Kiefer, Sarah M
The present research examined whether the nature of gender differences varies by race for two types of academic engagement in the classroom (help avoidance and voice with the teacher) in a sample of early adolescents (N = 456; 55% female, 60% African American and 40% European American) making the transition to middle school. Growth curve analyses indicated that help avoidance increased over time, voice remained stable, and achievement declined. In line with hypotheses based on cultural variations in the female role, there were no gender differences in help avoidance for African American students, whereas for European American students, girls were lower in help avoidance than were boys. For African American students, there were no gender differences in voice with the teacher, whereas for European American students, girls were higher than were boys. These group differences were present at all 3 waves. For all students, increases in help avoidance negatively predicted changes in achievement, whereas increases in voice positively predicted achievement. Results underscore the importance of examining gender and ethnicity together to understand academic adjustment during early adolescence.
Venkatesh, Ramesh; Kumar, Sumit
Purpose: The aim is to assess the prevalence, severity, and associations of back pain among Indian ophthalmologists. Methods: A self-reporting questionnaire was sent to ophthalmologists with valid e-mail addresses registered with the All India Ophthalmological Society. The survey was open for responses for 2 months. Results: A total of 651 (5.96%) responses were obtained; 394 (61%) males and 257 (39%) females. Half (50%) of responses were obtained from doctors belonging to 31–40 years' age group. Two hundred and thirty (35%) of the ophthalmologists had height ranging from 161 to 170 cm and 443 (68%) had weight ranging from 51 to 75 kg. Four hundred and eighty-one (73.8%) of the respondents had <15 years of ophthalmic experience. Cataract (346; 53.1%) and general ophthalmology (342; 52.5%) were commonly practised by the ophthalmologists. Time spent in the outpatient department (OPD) was 39.37 ± 16.32 h/week and in the operating theater 13.64 ± 9.89 h/week, respectively. Self-reported prevalence of back pain was 70.5%. Fully 49% of respondents had low back pain, followed by neck pain (33%) and upper extremity symptoms (16%). Age <50 years (odds ratio [OR] = 2.4485), female gender (OR = 2.0265), long working hours in OPD (OR = 1.6524), and performing retinal lasers and indirect ophthalmoscopy (OR = 3.3251) showed positive association with back pain. The intolerable back pain was noted in <7% of the respondents. Around 398 (61%) respondents felt that their back pain was exacerbated while doing work and 86.6% felt that up to 5 h/week was lost due to persistent backache. Yoga and some form of exercise (74.3%) was practised to alleviate back pain. Conclusion: Back pain symptoms appear to be common among ophthalmologists. Awkward posture and prolonged working hours are responsible for developing back pain among ophthalmologists. Performing yoga and regular exercises, modifications in instrumentation and creating a larger workforce of eye care practitioners are needed
Full Text Available Purpose: The aim is to assess the prevalence, severity, and associations of back pain among Indian ophthalmologists. Methods: A self-reporting questionnaire was sent to ophthalmologists with valid e-mail addresses registered with the All India Ophthalmological Society. The survey was open for responses for 2 months. Results: A total of 651 (5.96% responses were obtained; 394 (61% males and 257 (39% females. Half (50% of responses were obtained from doctors belonging to 31–40 years' age group. Two hundred and thirty (35% of the ophthalmologists had height ranging from 161 to 170 cm and 443 (68% had weight ranging from 51 to 75 kg. Four hundred and eighty-one (73.8% of the respondents had <15 years of ophthalmic experience. Cataract (346; 53.1% and general ophthalmology (342; 52.5% were commonly practised by the ophthalmologists. Time spent in the outpatient department (OPD was 39.37 ± 16.32 h/week and in the operating theater 13.64 ± 9.89 h/week, respectively. Self-reported prevalence of back pain was 70.5%. Fully 49% of respondents had low back pain, followed by neck pain (33% and upper extremity symptoms (16%. Age <50 years (odds ratio [OR] = 2.4485, female gender (OR = 2.0265, long working hours in OPD (OR = 1.6524, and performing retinal lasers and indirect ophthalmoscopy (OR = 3.3251 showed positive association with back pain. The intolerable back pain was noted in <7% of the respondents. Around 398 (61% respondents felt that their back pain was exacerbated while doing work and 86.6% felt that up to 5 h/week was lost due to persistent backache. Yoga and some form of exercise (74.3% was practised to alleviate back pain. Conclusion: Back pain symptoms appear to be common among ophthalmologists. Awkward posture and prolonged working hours are responsible for developing back pain among ophthalmologists. Performing yoga and regular exercises, modifications in instrumentation and creating a larger workforce of eye care practitioners are needed
Collins, Megan E; Mudie, Lucy I; Inns, Amanda J; Repka, Michael X
Reading difficulties are common in the pediatric population, and large socioeconomic disparities exist. In the United States 46% of white children achieved expected reading proficiency by the end of fourth grade, while only 21% of Hispanic and 18% of African American children were reading at the expected level. Reading is an involved cognitive process with many subskills; likewise, development of reading proficiency is a complex and continuous process. Failure to achieve reading proficiency or even early difficulty with reading can affect a child's academic performance for years to come. Some studies suggest reading proficiency may be related to later success in life. Although many problems with reading are not related to vision, a vision assessment is recommended for children with reading difficulties and a suspected vision problem. The process of reading development as well as the varied educational assessments of reading are presented here for pediatric ophthalmologists. Copyright © 2017 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.
Méndez-Ulrich, Jorge Luis; Sanz, Antoni
Asymptomatic in its early stages, glaucoma is the second leading cause of blindness worldwide. While psychosocial factors are taken into consideration for a host of diseases such as cancer, heart disease and autoimmune conditions, to date, psychological issues have been ignored in the clinical management of glaucoma. This work reviews the most relevant contributions from a health psychology perspective for the assessment and treatment of glaucoma, which is emerging in the field of psycho-ophthalmology. To provide scientific evidence regarding contributions of psychology to the comprehension of glaucoma, a bibliographic review of three databases (Psicodoc, PsycInfo and Medline) was conducted, spanning the period between 1940 and 2016. This review yielded a total of 66 studies published in the period analysed and identified three areas where health psychology has made substantive contributions to glaucoma screening, monitoring and treatment: the emotional impact on patients suffering from glaucoma, the adherence to treatment and the effects of stress on intraocular pressure. A health psychology approach for research and therapy of glaucoma must focus on the management of the negative affect associated with the diagnosis, the optimisation of treatment adherence and the stress management of the intraocular pressure measurements.
Full Text Available Jaime D Martinez,1 Anat Galor,2,3 Nallely Ramos-Betancourt,1 Andrés Lisker-Cervantes,1 Francisco Beltrán,1 Jorge Ozorno-Zárate,1 Valeria Sánchez-Huerta,1 Marco-Antonio Torres-Vera,1 Everardo Hernández-Quintela1 1Cornea and External Diseases Service, Asociación Para Evitar la Ceguera en Mexico (Association to prevent blindness in Mexico, Universidad Nacional Autónoma de México, Mexico City, Mexico; 2Department of Ophthalmology, Miami Veterans Affairs Medical Center, 3Cornea and External Diseases Division, Bascom Palmer Eye Institute, University of Miami, Miami, FL, USA Purpose: The purpose of this study was to ascertain the frequency and risk factors of dry eye (DE among patients attending a tertiary care ophthalmology center in Mexico.Methods: Approximately 338 consecutive new patients attending a tertiary care ophthalmology center in Mexico City underwent an ocular surface examination, which included tear film break-up time, fluorescein corneal staining, Schirmer’s test, and evaluation of meibum quality. Symptoms of DE were evaluated by the Ocular Surface Disease Index and Dry Eye Questionnaire-5. Information on demographics, exposures, past medical and ocular history, and medications was also collected.Results: The frequency of severe DE symptoms was found to be 43% based on the Ocular Surface Disease Index and 30% based on Dry Eye Questionnaire-5. Risk factors significantly associated with increased DE symptoms included dry mouth and gastrointestinal ulcer medications. With regard to signs, aqueous tear deficiency was a less-frequent finding (22% in our population than evaporative deficiency (94%. Risk factors associated with aqueous tear deficiency were dry mouth and diuretic use. No risk factors were associated with evaporative deficiency. Risk factors associated with meibomian gland dysfunction included old age, male sex, arthritis, and use of an antihypertensive. The only risk factor associated with corneal staining was dry
Jeffrey N Weiss
Full Text Available The Stem Cell Ophthalmology Treatment Study (SCOTS is currently the largest-scale stem cell ophthalmology trial registered at ClinicalTrials.gov (identifier: NCT01920867. SCOTS utilizes autologous bone marrow-derived stem cells (BMSCs to treat optic nerve and retinal diseases. Treatment approaches include a combination of retrobulbar, subtenon, intravitreal, intra-optic nerve, subretinal, and intravenous injection of autologous BMSCs according to the nature of the disease, the degree of visual loss, and any risk factors related to the treatments. Patients with Leber′s hereditary optic neuropathy had visual acuity gains on the Early Treatment Diabetic Retinopathy Study (ETDRS of up to 35 letters and Snellen acuity improvements from hand motion to 20/200 and from counting fingers to 20/100. Visual field improvements were noted. Macular and optic nerve head nerve fiber layer typically thickened. No serious complications were seen. The increases in visual acuity obtained in our study were encouraging and suggest that the use of autologous BMSCs as provided in SCOTS for ophthalmologic mitochondrial diseases including Leber′s hereditary optic neuropathy may be a viable treatment option.
Projections of future Canadian ratios of ophthalmologists to population have fluctuated because of changes in numbers of residency spots and retirement rates. Although this ratio plateaued in recent years, the ratio of ophthalmologists to the population over 65 years of age is projected to steadily deteriorate. All graduating residents are going to be needed to meet the upcoming workload, yet current graduates are finding increasing difficulty obtaining full-time positions with operating room privileges. This problem is affecting all specialties who require hospital facilities, and exploration of this problem by the Royal College, Canadian Medical Association (CMA), Resident Doctors of Canada, and council of the Provincial Deputy Ministers of Health is presented. Proposed solutions to the current job shortages include residents starting in positions outside of major metropolitan areas, clinicians in practice giving up some operating room time to make way for new graduates, government increasing infrastructure commensurate with the increased number of medical school positions, and optimizing use of current resources by running operating rooms for longer hours and on the weekends. Copyright © 2016 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.
Storey, Philip; Murchison, Ann P; Dai, Yang; Hark, Lisa; Pizzi, Laura T; Leiby, Benjamin E; Haller, Julia A
To compare methodologies for imputing ethnicity in an urban ophthalmology clinic. Using data from 19,165 patients with self-reported ethnicity, surname, and home address, we compared the accuracy of three methodologies for imputing ethnicity: (1) a surname method based on tabulation from the 2000 US Census; (2) a geocoding method based on tract data from the 2010 US Census; and (3) a combined surname geocoding method using Bayes' theorem. The combined surname geocoding model had the highest accuracy of the three methodologies, imputing black ethnicity with a sensitivity of 84% and positive predictive value (PPV) of 94%, white ethnicity with a sensitivity of 92% and PPV of 82%, Hispanic ethnicity with a sensitivity of 77% and PPV of 71%, and Asian ethnicity with a sensitivity of 83% and PPV of 79%. Overall agreement of imputed and self-reported ethnicity was fair for the surname method (κ 0.23), moderate for the geocoding method (κ 0.58), and strong for the combined method (κ 0.76). A methodology combining surname analysis and Census tract data using Bayes' theorem to determine ethnicity is superior to other methods tested and is ideally suited for research purposes of clinical and administrative data.
Wu, Chuhan; Zhang, Xiaofang; Chen, Weilin
Recently the combination of adaptive optics and ophthalmology has made great progress and become highly effective. The retina disease is diagnosed by retina imaging technique based on scanning optical system, so the scanning of eye requires optical system characterized by great ability of anti-moving and optical aberration correction. The adaptive optics possesses high level of adaptability and is available for real time imaging, which meets the requirement of medical retina detection with accurate images. Now the Scanning Laser Ophthalmoscope and the Optical Coherence Tomography are widely used, which are the core techniques in the area of medical retina detection. Based on the above techniques, in China, a few adaptive optics systems used for eye medical scanning have been designed by some researchers from The Institute of Optics And Electronics of CAS(The Chinese Academy of Sciences); some foreign research institutions have adopted other methods to eliminate the interference of eye moving and optical aberration; there are many relevant patents at home and abroad. In this paper, the principles and relevant technique details of the Scanning Laser Ophthalmoscope and the Optical Coherence Tomography are described. And the recent development and progress of adaptive optics in the field of eye retina imaging are analyzed and summarized.
Timothy J Doyle
Full Text Available Epidemic keratoconjunctivitis (EKC is an acute eye infection caused by adenovirus. We investigated an outbreak of EKC at an outpatient ophthalmology practice in the context of a suspected community wide increase in EKC activity. A site visit was made to the facility reporting the outbreak. A line list was created of patients clinically diagnosed with EKC at the practice during the previous 5 months. A questionnaire was faxed to all other licensed ophthalmologists in the county regarding recent EKC activity in their facility. Descriptive data analyses were conducted. The outbreak facility reported 37 patients clinically diagnosed with EKC during the previous 5 months. In addition, the single ophthalmologist at the practice also had symptoms compatible with EKC during the outbreak period. Specimens were collected on 4 patients and all were positive for adenovirus serotype 8. Forty percent of ophthalmologists surveyed in the county saw at least one EKC patient in the previous 3 months, and 20% reported a perceived increase in EKC activity in recent months over normal seasonal patterns. The outbreak at the facility likely began as part of a widespread community increase in EKC that may have been amplified at the facility through nosocomial transmission. Medical providers experiencing increases in EKC activity above seasonally expected norms should contact their public health department for assistance with etiologic diagnoses and outbreak control.
Birch, Eileen E; Kelly, Krista R
Reading is a major life activity, as recognized by the US Congress in the Americans with Disabilities Act Amendments Act of 2008, and the education code of most US states requires schools to evaluate reading and implement reading programs to addresses students' reading difficulties. Currently, such legislation is employed to identify accommodations needed for children with bilateral visual impairment and for children with dyslexia and/or related learning disabilities. Yet recent research has shown that children with the most common form of monocular visual impairment-amblyopia-read slowly. Slow reading can be detrimental to academic performance and learning, which in turn may affect self-esteem. Parents and educators can work together to implement accommodations (eg, extra time) to help amblyopic students succeed in their daily school tasks, and improve their performance on the timed, standardized tests that are critical for promotion and admission to magnet schools, TAG programs, high schools, and colleges. Children with other visual disorders that cause visual impairment in one eye (eg, glaucoma, cataract, trauma, etc) should also be considered for academic accommodations. Copyright © 2017 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.
Full Text Available Introduction. Serbia has 2.287 registered HIV positive persons. A certain number has ocular complications which are mainly the result of opportunistic infections accompanying this illness. Due to a highly stigmatizing environment for people living with HIV/AIDS in Serbia, they do not always seek doctors assistance despite the fear of losing their sight. Case report. We presented ophthalmologic status of nine HIV positive persons, all at the different phases of the illness. The decrease in the visual acuity was the first symptom which led to the diagnosis of HIV infection in two of our patients. Conclusion. Ophthalmologist has an important role in the multidisciplinary approach to patients with HIV/AIDS from introducing the diagnosis to the follow-up and the treatment of ocular complications which may accompany this chronic illness. With the active involvement of eye professionals serious consequences can be prevented, which have not only medical but also social and economic implications on the individual and the society as a whole.
Full Text Available Ioannis T Tsinopoulos, Chrysanthos Symeonidis, Konstantinos T Tsaousis, Asimina Mataftsi, Nikolaos Chalvatzis, Argyrios Tzamalis, Lampros P Lamprogiannis, Stavros A Dimitrakos2nd Department of Ophthalmology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Macedonia, GreecePurpose: Conventional medical curriculum is the rule of medical teaching in Greek Medical Schools. Medical students are often taught irrelevant details with little or no reference to their potential clinical significance. Alternatively, integrated teaching warrants that the complete teaching material is covered by each faculty member not considering areas of personal expertise. The aim of this study was to evaluate the implementation of integrated teaching in ophthalmic training.Methods: The main outcome measures of this retrospective study were a comments and recommendations made anonymously by the fifth-year medical students in the evaluation questionnaires filled in at the end of their training, and b scores obtained by students in their final examination at the end of their training in the 2nd Department of Ophthalmology as part of the core Curriculum of the Medical School of the Aristotle University of Thessaloniki. The latter outcome was analyzed with respect to the implementation of integrated teaching.Results: The score obtained by students in the final examination, which is an objective outcome measure, increased significantly after the implementation of integrated teaching. The final grade (scores out of 10 of students who were trained with the integrated system (6.17±1.67, mean ± standard deviation was significantly higher compared to those (5.52±2.20 trained with the conventional system (P<0.001. The positive outcome of this process was evident as there was a significant increase in the number of students satisfied with the teaching process compared to previous academic years.Conclusion: Based on the experience of eight academic years and as a
Micieli, Jonathan A; Tsui, Edmund
The use of social media in ophthalmology remains largely unknown. Our aim was to evaluate the extent and involvement of ophthalmology journals, professional associations, trade publications, and patient advocacy and fundraising groups on social networking sites. An archived list of 107 ophthalmology journals from SCImago, trade publications, professional ophthalmology associations, and patient advocacy organizations were searched for their presence on Facebook, Twitter, and LinkedIn. Activity and popularity of each account was quantified by using the number of "likes" on Facebook, the number of followers on Twitter, and members on LinkedIn. Of the 107 journals ranked by SCImago, 21.5% were present on Facebook and 18.7% were present on Twitter. Journal of Community Eye Health was the most popular on Facebook and JAMA Ophthalmology was most popular on Twitter. Among the 133 members of the International Council of Ophthalmology, 17.3% were present on Facebook, 12.8% were present on Twitter, and 7.5% were present on LinkedIn. The most popular on Facebook was the International Council of Ophthalmology, and the American Academy of Ophthalmology was most popular on Twitter and LinkedIn. Patient advocacy organizations were more popular on all sites compared with journals, professional association, and trade publications. Among the top ten most popular pages in each category, patient advocacy groups were most active followed by trade publications, professional associations, and journals. Patient advocacy groups lead the way in social networking followed by professional organizations and journals. Although some journals use social media, most have yet to engage its full potential and maximize the number of potential interested individuals.
Thomsen, Ann Sofia S; Subhi, Yousif; Kiilgaard, Jens Folke
ophthalmology, although it often lacks a scientific basis for implementation. METHODS: We conducted a systematic review of trials involving simulation-based training or assessment of ophthalmic surgical skills among health professionals. The search included 5 databases (PubMed, EMBASE, PsycINFO, Cochrane...... in ophthalmology is inadequate. To ensure effective implementation of training models, evidence-based knowledge of validity and efficacy is needed. We provide a useful tool for implementation and evaluation of research in simulation-based training....
Gheorghe, Consuela-Mădălina; Gheorghe, Iuliana-Raluca; Purcărea, Victor Lorin
Nowadays, we live in a world in which we are daily bombed by hundreds of advertisements. Specialists have to discover other channels or embed attractive elements in the advertisements’ messages to cut through the clutter and catch the consumers’ attention. The evolution of the concept of service has changed from the commercial status to determining a lifestyle. Buying a service has led to a change in the consumer behavior. Consumers want to buy services that dazzle their senses, touch their hearts, and stimulate their minds, not as before, excellent or satisfying. Ophthalmology is the medical specialty that is the most oriented toward outpatient care, as hospitalization is required only in a small percentage of cases. The objective of this case study was to investigate the perception of Romanian adult consumers on ophthalmology services from an experiential marketing perspective, by using the Focus Group method. Ophthalmology requires a wide range of skills due to the diversity of consumers who demand specialized consultations. Experiential marketing is a valuable strategy that ophthalmologic organizations may use to target specific consumers. The purpose of this case study was to identify the perceptions of Romanian adults on experiential marketing campaigns and determine the degree to which these campaigns influenced their decisions of buying an ophthalmologic service. Using a snowball sampling technique we have sent a filter questionnaire to 40 people on the internet. The filter questionnaire consisted of questions about wearing eyeglasses, the period of wearing them, the last ophthalmologic consultation, the type of ophthalmologic clinic they were going to, age and education. The respondents revealed there is almost no visibility on promoting services even if there is an upsurge of organizations offering this type of health service in the Romanian ophthalmology sector.
Mishra, Anuradha; Browning, David; Haviland, Miriam J; Jackson, Mary Lou; Luff, Donna; Meyer, Elaine C; Talcott, Katherine; Kloek, Carolyn E
To conduct a needs assessment to identify gaps in communication skills training in ophthalmology residency programs and to use these results to pilot a communication workshop that prepares residents for difficult conversations. A mixed-methods design was used to perform the needs assessment. A pre-and postsurvey was administered to workshop participants. Mass Eye and Ear Infirmary, Harvard Medical School (HMS), Department of Ophthalmology. HMS ophthalmology residents from postgraduate years 2-4 participated in the needs assessment and the workshop. Ophthalmology residency program directors in the United States participated in national needs assessment. Ophthalmology program directors across the United States were queried on their perception of resident communication skills training through an online survey. A targeted needs assessment in the form of a narrative exercise captured resident perspectives on communication in ophthalmology from HMS residents. A group of HMS residents participated in the pilot workshop and a pre- and postsurvey was administered to participants to assess its effectiveness. The survey of program directors yielded a response rate of 40%. Ninety percent of respondents agreed that the communication skills training in their programs could be improved. Fifteen of 24 residents (62%) completed the needs assessment. Qualitative analysis of the narrative material revealed four themes; (1) differing expectations, (2) work role and environment, (3) challenges specific to ophthalmology, and (4) successful strategies adopted. Nine residents participated in the workshop. There was a significant improvement post-workshop in resident reported scores on their ability to manage their emotions during difficult conversations (p = 0.03). There is an opportunity to improve communication skills training in ophthalmology residency through formalized curriculum. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights
Gheorghe, Consuela-Mădălina; Gheorghe, Iuliana-Raluca; Purcărea, Victor Lorin
Nowadays, we live in a world in which we are daily bombed by hundreds of advertisements. Specialists have to discover other channels or embed attractive elements in the advertisements' messages to cut through the clutter and catch the consumers' attention. The evolution of the concept of service has changed from the commercial status to determining a lifestyle. Buying a service has led to a change in the consumer behavior. Consumers want to buy services that dazzle their senses, touch their hearts, and stimulate their minds, not as before, excellent or satisfying. Ophthalmology is the medical specialty that is the most oriented toward outpatient care, as hospitalization is required only in a small percentage of cases. The objective of this case study was to investigate the perception of Romanian adult consumers on ophthalmology services from an experiential marketing perspective, by using the Focus Group method. Ophthalmology requires a wide range of skills due to the diversity of consumers who demand specialized consultations. Experiential marketing is a valuable strategy that ophthalmologic organizations may use to target specific consumers. The purpose of this case study was to identify the perceptions of Romanian adults on experiential marketing campaigns and determine the degree to which these campaigns influenced their decisions of buying an ophthalmologic service. Using a snowball sampling technique we have sent a filter questionnaire to 40 people on the internet. The filter questionnaire consisted of questions about wearing eyeglasses, the period of wearing them, the last ophthalmologic consultation, the type of ophthalmologic clinic they were going to, age and education. The respondents revealed there is almost no visibility on promoting services even if there is an upsurge of organizations offering this type of health service in the Romanian ophthalmology sector.
Mathew, Rashmi G; Ferguson, Veronica; Hingorani, Melanie
To categorize and understand the reasons behind ophthalmic clinical negligence claims in the National Health Service and how such claims can be avoided. Retrospective analyses of all ophthalmic clinical negligence claims between 1995 and 2009 were carried out. Data were obtained from the National Health Service Litigation Authority through the Freedom of Information Act. Claims were classified according to ophthalmic subspecialty, mean payment per subspecialty, severity, paid-to-closed ratio, and cost. One thousand two hundred fifty-three ophthalmology-related claims occurring from 1995 through 2009. Of these, 963 claims were closed over the 15-year period. Eighty-four were excluded because of insufficient case data. Retrospective analysis of all public sector ophthalmology litigation claims over a 15-year period in England. Subspecialty pertaining to claim, mean payment per claim, and severity of outcome of clinical incident. Nine hundred sixty-three claims were closed over a 15-year period, of which 67% resulted in payment. The total cost of claims was £32.1 million ($50.3 million), with a mean payment per claim of £33 300 ($52 300). The specialties with the highest mean payment per claim were neuro-ophthalmology and pediatric ophthalmology. Cataract subspecialty had the highest number of claims, accounting for 34% of all claims. Overall, the number of litigation claims in ophthalmology is low, relative to the high volume of outpatient and surgical workload. Copyright © 2013 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.
van Meel, Evelien R; den Dekker, Herman T; Elbert, Niels J; Jansen, Pauline W; Moll, Henriëtte A; Reiss, Irwin K; de Jongste, Johan C; Jaddoe, Vincent W V; Duijts, Liesbeth
Early-life respiratory tract infections could affect airway obstruction and increase asthma risk in later life. However, results from previous studies are inconsistent. We examined the associations of early-life respiratory tract infections with lung function and asthma in school-aged children. This study among 5197 children born between April 2002 and January 2006 was embedded in a population-based prospective cohort study. Information on physician-attended upper and lower respiratory tract infections until age 6 years (categorised into ≤3 and >3-6 years) was obtained by annual questionnaires. Spirometry measures and physician-diagnosed asthma were assessed at age 10 years. Upper respiratory tract infections were not associated with adverse respiratory outcomes. Compared with children without lower respiratory tract infections ≤3 years, children with lower respiratory tract infections ≤3 years had a lower FEV1, FVC, FEV1:FVC and forced expiratory flow at 75% of FVC (FEF75) (Z-score (95% CI): ranging from -0.22 (-0.31 to -0.12) to -0.12 (-0.21 to -0.03)) and an increased risk of asthma (OR (95% CI): 1.79 (1.19 to 2.59)). Children with lower respiratory tract infections >3-6 years had an increased risk of asthma (3.53 (2.37 to 5.17)) only. Results were not mediated by antibiotic or paracetamol use and not modified by inhalant allergic sensitisation. Cross-lagged modelling showed that results were not bidirectional and independent of preschool wheezing patterns. Early-life lower respiratory tract infections ≤3 years are most consistently associated with lower lung function and increased risk of asthma in school-aged children. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Hermann AM Mucke
Full Text Available Hermann AM Mucke, Peter Mucke, Eva MuckeHM Pharma Consultancy, Vienna, AustriaAbstract: While investigative ophthalmologists access peer-reviewed journals as part of their daily routine, and while they regularly visit scientific congresses, they rarely peruse patent documents as an information source. Among the reasons for this negligence are the incompatibility of patent search algorithms with those known from journal databases, a legalistic and frequently redundant language, and misconceptions about the nature of the patenting system. Here we present key data and analyses from the ophthalmology module of a patent database system that we are developing to address some of these problems. We show that international patent applications consistently reflect developer interest in the ocular drug and diagnostics field; that they are technically focused lead indicators of developments that frequently feature in peer-reviewed patenting only much later; and that patenting targets are well aligned with the unmet therapeutic needs of populations in industrialized countries. Most applications (74%–78% in years since 2006 are supported with experimental data, and most (on average, 80%–90% faced at least one objection to patentability during their initial stage of examination. In contrast to the peer-reviewed scenery that is highly diverse, the corresponding patenting arena shows a pronounced focus on the United States.Keywords: ophthalmology, eye diseases, iontophoresis, intellectual property, patents as topic, bibliographic databases
Raab, Edward L.
The examination of a child for strabismus (misalignment of the eyes) and treatment if the condition is present are described. General considerations when evaluating need of surgery are presented. Steps in the ophthalmologic examination are discussed, including such tests as extraocular muscle function and traction testing and studies of eye…
Mohammad Reza Ghane
Full Text Available Background: Rapid Ultrasound in Shock (RUSH is a recently reported emergency ultrasound protocol designed to help clinicians better recognize distinctive shock etiologies in a short time. We tried to evaluate the accuracy of early RUSH protocol performed by emergency physicians to predict the shock type in critically ill patients. Materials and Methods: Our prospective study was approved by the ethics committee of trauma research center, Baqiyatallah University of Medical Science, Iran. We enrolled 52 patients with shock state in the emergency department from April 2013 to October 2013. We performed early bed-side sonographic examination for participants based on RUSH protocol. Patients received all needed standard therapeutic and diagnostic interventions without delay and were followed to document their final diagnosis. Agreement (Kappa index of initial impression provided by RUSH with final diagnosis, and also sensitivity, specificity, positive predictive value (PPV, and negative predictive value (NPV of RUSH for diagnosis of each shock type were calculated. Results: Fifty-two patients were enrolled in our study. Kappa index was 0.7 (P value = 0.000, reflecting acceptable general agreement between initial impression and final diagnosis. For hypovolemic and obstructive shocks, the protocol had sensitivity of 100% but had lower PPV. For shocks with distributive or mixed etiology, RUSH showed PPV of 100% but had low sensitivity. For cardiogenic shocks, all reliability indices were above 90%. Conclusion: We highlight the role of RUSH examination in the hands of an emergency physician in making a rapid diagnosis of shock etiology, especially in ruling out obstructive, cardiogenic, and hypovolemic types.
Rusciano, Giulia; Capriglione, Paola; Pesce, Giuseppe; Zito, Gianluigi; Del Prete, Antonio; Cennamo, Giovanni; Sasso, Antonio
Cell-based biosensors rely on the detection and identification of single cells as well as monitoring of changes induced by interaction with drugs and/or toxic agents. Raman spectroscopy is a powerful tool to reach this goal, being non-destructive analytical technique, allowing also measurements of samples in aqueous environment. In addition, micro-Raman measurements do not require preliminary sample preparation (as in fluorescence spectroscopy), show a finger-print spectral response, allow a spatial resolution below typical cell sizes, and are relatively fast (few s or even less). All these properties make micro-Raman technique particularly promising for high-throughput on-line analysis integrated in lab-on-a-chip devices. Herein, we demonstrate some applications of Raman analysis in ophthalmology. In particular, we demonstrate that Raman analysis can provide useful information for the therapeutic treatment of keratitis caused by Acanthamoeba Castellanii (A.), an opportunistic protozoan that is widely distributed in the environment and is known to produce blinding keratitis and fatal encephalitis. In particular, by combining Raman analysis with Principal Component Analysis (PCA), we have demonstrated that is possible to distinguish between live and dead cells, enabling, therefore to establish the effectiveness of therapeutic strategies to vanquish the protozoa. As final step, we have analyzed the presence of biochemical differences in the conjunctival epithelial tissues of patients affected by keratitis with respect to healthy people. As a matter of facts, it is possible to speculate some biochemical alterations of the epithelial tissues, rendering more favorable the binding of the protozoan. The epithelial cells were obtained by impression cytology from eyes of both healthy and keratitis-affected individuals. All the samples were analyzed by Raman spectroscopy within a few hours from cells removal from eyes. The results of this analysis are discussed.
Crabb, Jim; McAllister, Mark; Blair, Alison
It has been established that patients with severe mental illness are at increased risk of physical illness and that physical health screening should be performed when an individual experiences a first episode of psychosis. The aim of the audit was to examine how physical health screening was achieved in the real world of an early intervention in psychosis (EIP) service in Scotland. Of particular interest was considering if primary or secondary care were more effective in providing specific physical health assessment for those presenting to the service. A case note audit was performed. The audit shows that physical examination and blood tests were being completed in the majority of service users under the care of the Esteem service. However, an unacceptably high number were not undergoing sufficient initial screening for metabolic syndrome or having baseline monitoring prior to commencing antipsychotic medication. Our results suggest that relying on primary care to provide physical health screening was not an effective approach in a population experiencing first-episode psychosis. Having a psychiatrist motivated to perform physical health screening within the EIP team may help to improve the uptake of physical health screening. Strategies to improve physical health screening in EIP services are discussed. © 2009 The Authors. Journal compilation © 2009 Blackwell Publishing Asia Pty Ltd.
Berardi, Alberto; Fornaciari, Sara; Rossi, Cecilia; Patianna, Viviana; Bacchi Reggiani, Maria Letizia; Ferrari, Filippo; Neri, Isabella; Ferrari, Fabrizio
The published data to support recommendations for prevention and management of well-appearing at-risk newborns (WAARNs) for early-onset sepsis (EOS) are limited. Retrospective cohort study comparing two different strategies for managing WAARNs (≥ 35 weeks' gestation) during a 6-year period (Period 1, from 2005 to 2007; Period 2, from 2009 to 2011). WAARNs were defined as healthy-appearing neonates evaluated because of risk factors for EOS. Laboratory evaluation plus simplified physical examination (Period 1) was compared with physical examination alone (PEA, Period 2). The use of antibiotics, the length of stay, the timeliness of diagnosis and the risk of falling ill immediately after hospital discharge in both periods were also compared. WAARNs receiving empirical antibiotics were 14/500 (Period 1) and 3/500 (Period 2, p = 0.01). Median length of stay was 4 (Period 1) and 3 days (Period 2, p = 0.04). Symptoms of EOS were earlier than laboratory evaluation results in 42/44 neonates. Severe disease was diagnosed within 6 h of life in all neonates. No WAARNs presented with EOS following hospital discharge. WAARNs managed through PEA received less unnecessary antibiotics and had a shorter length of stay. They had no increased risk of severe complications or increased risk of becoming ill following hospital discharge.
Schrempft, Stephanie; van Jaarsveld, Cornelia Hm; Fisher, Abigail
The obesogenic home environment is usually examined via self-report, and objective measures are required. This study explored whether the wearable camera SenseCam can be used to examine the early obesogenic home environment and whether it is useful for validation of self-report measures. A total of 15 primary caregivers of young children (mean age of child 4 years) completed the Home Environment Interview (HEI). Around 12 days after the HEI, participants wore the SenseCam at home for 4 days. A semistructured interview assessed participants' experience of wearing the SenseCam. Intraclass correlation coefficients (ICCs), percent agreement, and kappa statistics were used as validity estimates for 54 home environment features. Wearing the SenseCam was generally acceptable to those who participated. The SenseCam captured all 54 HEI features but with varying detail; 36 features (67%) had satisfactory validity (ICC or kappa ≥0.40; percent agreement ≥80 where kappa could not be calculated). Validity was good or excellent (ICC or kappa ≥0.60) for fresh fruit and vegetable availability, fresh vegetable variety, display of food and drink (except sweet snacks), family meals, child eating lunch or dinner while watching TV, garden and play equipment, the number of TVs and DVD players, and media equipment in the child's bedroom. Validity was poor (ICC or kappa obesogenic home environment. Further research should aim to replicate the findings in a larger, representative sample.
Goda, Tatsuro; Matsuno, Ryosuke; Konno, Tomohiro; Takai, Madoka; Ishihara, Kazuhiko
The biomimetic structure of a polymer hydrogel bearing phosphorylcholine groups was obtained from 2-methacryloyloxyethylphosphorylcholline (MPC) and a novel crosslinker, 2-(methacryloyloxy)ethyl-N-(2-methacryloyloxy)ethyl]phosphorylcholine (MMPC), to prepare biocompatible ocular materials. MMPC is a dimethacrylate with phosphorylcholine-analogous linkage. Previous reports clarified that the affinity of MMPC to MPC enables the water contents and mechanical properties of the poly(MPC) hydrogels to be varied without disturbing the bulk phases. In this study, we examined the protein adsorption resistance, water wettability, oxygen permeability, and electrolyte permeability of the mechanically enhanced poly(MPC) hydrogel crosslinked with MMPC. The amount of protein adsorbed on this hydrogel was 0.9 microg/cm(2), which accounted for 30% of Omafilcon A and 3% of Etafilcon A. Water contact angle experiments revealed the high wettability of the poly(MPC) hydrogels. The oxygen permeability and NaCl diffusion constant of the poly(MPC) hydrogels were 64 barrer and 48 x 10(-6) cm(2)/s, respectively. This high permeability resulted from the high water content, similar to the case of the human cornea. These results suggested that poly(MPC) hydrogels have good potential for use in ophthalmologic biomaterials.
Hill, Sophie; Dennick, Reg
Objectives To investigate the current undergraduate ophthalmology curricula provided by the UK medical schools, evaluate how they compare with the guidelines of the Royal College of Ophthalmologists (RCOphth) and International Council for Ophthalmology (ICO), and determine the views of the UK ophthalmology teaching leads on the future direction of the curriculum. Methods A cross-sectional questionnaire was sent to teaching leads in 31 medical schools across the UK. The questionnaire evaluated eight themes of the curriculum: content and learning outcomes, communication of learning outcomes, organisation of the curriculum, assessment, educational resources, teaching methods used, and the educational environment. The ophthalmology teaching leads were also asked their opinion on the current and future management of the curriculum. These were compared with RCOphth and ICO guidelines and descriptive statistical analysis performed. Results A response rate of 93% (n=29/31) was achieved. The knowledge and clinical skills taught by the UK medical schools match the RCOphth guidelines, but fail to meet the ICO recommendations. A diverse range of assessment methods are used by UK medical schools during ophthalmology rotations. Variation was also observed in the organisation and methods of ophthalmology teaching. However, a significant consensus about the future direction of the curriculum was reported by teaching leads. Conclusions Comprehensive RCOphth guidance, and resource sharing between medical schools could help to ensure ophthalmology’s continuing presence in the medical curriculum and improve the effectiveness of undergraduate ophthalmology teaching, while reducing the workload of local teaching departments and medical schools. PMID:29103017
Mertz, M; Mann, G; Zahlmann, G; Obermaier, M
In Denmark, France, Germany, Great Britain and Italy, the OPHTEL project combines clinical centers of ophthalmology and internal medicine, an institute for medical informatics and health services research, a publishing company and different industrial partners in the EDP market. With the aid of visual telecommunication and rapid data transfer, methods and conditions will be developed and proved so that any physician can very easily obtain sufficient information for treating his patient. Thus, the regional differences in the quality of structured health service (e.g., urban/ rural) will be overcome throughout Europe. SCIENTIFIC TASKS: A multilingual diagnostic and therapeutic thesaurus has to be worked out in order to create standards for communication and quality control. Based on literature, images and image analysis in a knowledge-based data bank, a monitoring system (containing watch-dog functions) and the basic aspects of an ophthalmological patient/disease register will be investigated. (In parallel, a technical development of synchronous and asynchronous telecommunication between eye physicians is taking place in close cooperation with the regional Bavarian project Teleopathalmology in Bavaria on-line). State of the art 6 months after starting the project:the knowledge-based image data bank has been founded and also an ophthalmological 8 language thesaurus and definition standard. All data transfer lines are installed. The project is taking place amid diverging sections of medicine: ophthalmology and internal medicine, health politics and data protection, individual treatment and common interest (health care), product management and office organization. Thus, the scientific quality of the transferred ophthalmological content must undergo sophisticated controls. FUTURE STEPS: Intense cooperation with the big German associations for ophthalmology (DOG, BVA) and the European ophthalmological societies concerning EDP, classification and quality control.
Full Text Available Objective: The aim of this study is to obtain the thoughts, knowledge levels and training needs’ of the family medicine residents in Ankara about ophthalmology. Also with this study, we aimed to raise awareness on this issue and guide the studies that aimed to promote standard care for ophthalmology patients. Methods: Between 01/04/2015-01/05/2015, we applied a questionnaire, developed by researchers to the family medicine residents who were working at a training and research/ university hospital in Ankara. We reached to the 200 family medicine residents to join to the survey but 196 of them completed the questionnaire. Data analysis was performed with SPSS 21.0 for Windows application. Results: Only 12.8% of the residents think that the ophthalmology training given in the medicine faculty is enough, but 54.1% of them disagree and 33.2% of them partially agree. It was found that the most common cause of inadequate training in medical faculty is lack of practice. 9.5% of the family medicine residents agree that the ophthalmology training given during the family medicine specialization training is enough but 67.5% of them disagree and 20.5% of them partially agree. Residents think that ophthalmology education in family medicine training is not sufficient because Ophthalmology rotation is optional in the curriculum. Conclusion: The curriculum of family medicine specialization training should include both practical and theorical trainings for the primary health care. In this context, compulsory and elective clinical rotations are an important part of specialization training. Only 9.5% of the participants agree that the ophthalmology training given during the family medicine specialization training is enough. It was thought that the results of the study will raise awareness on this issue and help the new studies about developing the approaches to the patients with eye diseases in primary care. J Clin Exp Invest 2015; 6 (4: 369-374
Chiang, Michael F.; Read-Brown, Sarah; Tu, Daniel C.; Choi, Dongseok; Sanders, David S.; Hwang, Thomas S.; Bailey, Steven; Karr, Daniel J.; Cottle, Elizabeth; Morrison, John C.; Wilson, David J.; Yackel, Thomas R.
Purpose: To evaluate three measures related to electronic health record (EHR) implementation: clinical volume, time requirements, and nature of clinical documentation. Comparison is made to baseline paper documentation. Methods: An academic ophthalmology department implemented an EHR in 2006. A study population was defined of faculty providers who worked the 5 months before and after implementation. Clinical volumes, as well as time length for each patient encounter, were collected from the EHR reporting system. To directly compare time requirements, two faculty providers who utilized both paper and EHR systems completed time-motion logs to record the number of patients, clinic time, and nonclinic time to complete documentation. Faculty providers and databases were queried to identify patient records containing both paper and EHR notes, from which three cases were identified to illustrate representative documentation differences. Results: Twenty-three faculty providers completed 120,490 clinical encounters during a 3-year study period. Compared to baseline clinical volume from 3 months pre-implementation, the post-implementation volume was 88% in quarter 1, 93% in year 1, 97% in year 2, and 97% in year 3. Among all encounters, 75% were completed within 1.7 days after beginning documentation. The mean total time per patient was 6.8 minutes longer with EHR than paper (P<.01). EHR documentation involved greater reliance on textual interpretation of clinical findings, whereas paper notes used more graphical representations, and EHR notes were longer and included automatically generated text. Conclusion: This EHR implementation was associated with increased documentation time, little or no increase in clinical volume, and changes in the nature of ophthalmic documentation. PMID:24167326
Chiang, Michael F; Read-Brown, Sarah; Tu, Daniel C; Choi, Dongseok; Sanders, David S; Hwang, Thomas S; Bailey, Steven; Karr, Daniel J; Cottle, Elizabeth; Morrison, John C; Wilson, David J; Yackel, Thomas R
To evaluate three measures related to electronic health record (EHR) implementation: clinical volume, time requirements, and nature of clinical documentation. Comparison is made to baseline paper documentation. An academic ophthalmology department implemented an EHR in 2006. A study population was defined of faculty providers who worked the 5 months before and after implementation. Clinical volumes, as well as time length for each patient encounter, were collected from the EHR reporting system. To directly compare time requirements, two faculty providers who utilized both paper and EHR systems completed time-motion logs to record the number of patients, clinic time, and nonclinic time to complete documentation. Faculty providers and databases were queried to identify patient records containing both paper and EHR notes, from which three cases were identified to illustrate representative documentation differences. Twenty-three faculty providers completed 120,490 clinical encounters during a 3-year study period. Compared to baseline clinical volume from 3 months pre-implementation, the post-implementation volume was 88% in quarter 1, 93% in year 1, 97% in year 2, and 97% in year 3. Among all encounters, 75% were completed within 1.7 days after beginning documentation. The mean total time per patient was 6.8 minutes longer with EHR than paper (P<.01). EHR documentation involved greater reliance on textual interpretation of clinical findings, whereas paper notes used more graphical representations, and EHR notes were longer and included automatically generated text. This EHR implementation was associated with increased documentation time, little or no increase in clinical volume, and changes in the nature of ophthalmic documentation.
El Bahloul, M; Chraïbi, F; Aounzou, S; Salam Diarra, A; Abdellaoui, M; Benatiya, I; Tahri, H
To evaluate the efficacy of intravitreal bevacizumab in the treatment of choroidal neovascularization (CNV) secondary to angioid streaks. We conducted a prospective study in the ophthalmology department of Hassan II university hospital in Fez, including 12 eyes of 7 patients with CNV associated with angioid streaks. We injected 8 eyes with bevacizumab 1.25mg; best corrected visual acuity (BCVA), fundus examination, fluorescein angiography and optical coherence tomography were performed and analyzed for all patients before and after treatment. The goal of the study was to determine the percentage of patients with stabilization or improvement in BCVA and decreased central macular thickness. Visual acuity on admission was <1/10 in 75% of patients. We injected 8 eyes with anti-VEGF, whereas abstention was appropriate for 4 eyes with disciform scarring. The average number of bevacizumab injections was 4.3±1.3 over a mean follow-up of 14.57 months±5.3. After treatment, BCVA was <1/10 in 12.5% of cases, between 1/10 and 5/10 in 50% of cases, and in 37.5% of patients, it was ≥5/10. Mean central macular thickness decreased from 424.25±137.03μm on admission to 255.75 microns±50.14 post-treatment (P=0.005). Intravitreal bevacizumab is a promising and effective treatment option for the management of CNV associated with angioid streaks, with the requirement however of early treatment and extended follow-up. Copyright © 2017 Elsevier Masson SAS. All rights reserved.
Rosa Maria Graziano
Full Text Available OBJETIVO: Revisar conceitos do desenvolvimento visual e principais alterações oculares do recém-nascido prematuro. Salientar a importância do exame oftalmológico preventivo e tratamento precoce das doenças oculares. FONTE DOS DADOS: Dados de literatura. SÍNTESE DE DADOS: A visão é um dos mais importantes sentidos no desenvolvimento físico e cognitivo normal da criança. Em recém-nascido prematuro, as funções visual, motora e cognitiva, quando comparadas às de crianças de termo em idade escolar, são prejudicadas. Isto se deve mais à imaturidade do sistema nervoso central do que a lesões localizadas em estruturas oculares e/ou corticais. A retinopatia da prematuridade, o estrabismo e os erros de refração são as principais alterações oftálmicas secundárias à prematuridade descritas na literatura. A retinopatia da prematuridade é uma das principais causas de cegueira prevenível na infância. Calcula-se que, em média, 562 crianças fiquem cegas por ano no Brasil, um custo socioeconômico alto, principalmente por se tratar de uma doença passível de tratamento. Muito pode ser feito pela criança com deficiência visual; programas de estimulação visual precoce permitem que a criança possa ter uma integração maior com seu meio. CONCLUSÕES: Recomenda-se que todo recém-nascido prematuro com p OBJECTIVES: To review the concepts of visual development and the major ocular abnormalities in preterm newborns. To emphasize the importance of preventive ophthalmologic examination and early treatment of ocular disorders. SOURCES OF DATA: A review of published data. SUMMARY OF FINDINGS: Vision is one of the most important senses in the normal physical and cognitive development of children. Schoolchildren who were born preterm have impaired visual, motor and cognitive functions when compared to those of children born full term. This is more a consequence of central nervous system immaturity than of localized injuries to ocular and
S. Yu. Petrov
Full Text Available Oxygen content in body fluids and tissues is an important indicator of life support functions. A number of ocular pathologies, e.g. glaucoma, are of presumable vascular origin which means altered blood supply and oxygen circulation. Most oxygen is transported in the blood in the association with hemoglobin. When passing through the capillaries, hemoglobin releases oxygen, converting from oxygenated form to deoxygenated form. This process is accompanied by the changes in spectral characteristics of hemoglobin which result in different colors of arterial and venous blood. Photometric technique for the measurement of oxygen saturation in blood is based on the differences in light absorption by different forms of hemoglobin. The measurement of saturation is called oximetry. Pulse oximetry with assessment of tissue oxygenation is the most commonly used method in medicine. The degree of hemoglobin oxygen saturation in the eye blood vessels is the most accessible for noninvasive studies during ophthalmoscopy and informative. Numerous studies showed the importance of this parameter for the diagnosis of retinopathy of various genesis, metabolic status analysis in hyperglycemia, diagnosis and control of treatment of glaucoma and other diseases involving alterations in eye blood supply. The specific method for evaluation of oxygen concentration is the measurement of pressure of oxygen dissolved in the blood, i.e. partial pressure of oxygen. In ophthalmological practice, this parameter is measured in anterior chamber fluid evaluating oxygen level for several ophthalmopathies including different forms of glaucoma, for instillations of hypotensive eye drops as well as in vitreous body near to the optic disc under various levels of intraocular pressure. Currently, monitoring of oxygen saturation in retinal blood vessels, i.e. retinal oximetry, is well developed. This technique is based on the assessment of light absorption by blood depending on
Schelenz, D; Kleiter, I; Schöllhammer, J; Rehrmann, J; Elling, M; Dick, H B; Kakkassery, V
Fingolimod, a disease-modifying sphingosine 1‑phosphate receptor modulator, which was approved in Germany in 2011, decreases the relapse rate and reduces neuroinflammation in patients with relapsing-remitting multiple sclerosis. Macular edema is a well-known ocular side effect of fingolimod therapy. Specific intervals for ophthalmologic check-ups after starting fingolimod and definite treatment schedules for fingolimod-associated macular edema are, however, still lacking. We present a case of early fingolimod-associated macular edema in a 45-year-old female patient with relapsing-remitting multiple sclerosis. The patient complained about visual impairment 1 month after the start of fingolimod and visited an eye specialist. Funduscopic examination and imaging diagnostics revealed macular edema in both eyes. The treatment with fingolimod was immediately stopped. For therapy of macular edema topical application of nepafenac and oral acetazolamide were given. During the 6 months of treatment the macular edema completely disappeared and visual function recovered completely. At the time of diagnosis, it is fundamentally important to discuss the continuation of fingolimod administration with the attending neurologist and if necessary to discontinue the drug. Regular ophthalmologic check-ups at 4‑week intervals over a period of 3 months are meaningful after beginning fingolimod treatment. As before, it is still a key aspect to determine predictive opthalmologic and neurological factors before beginning treatment to evaluate which patients are at risk of fingolimod-associated macular edema.
Ohba, Norio; Nakao, Kumiko
We screened 32 ophthalmology journals that had published articles during the period from 1850 through 1949 to identify top-cited articles in the field of ophthalmology (hereafter referred to as citation classics) using the online database Science Citation Index Expanded (Thompson Reuters, Chicago, Illinois). The 101 most frequently cited articles were published in 16 journals. Archives of Ophthalmology had the most top-cited articles (n = 31), followed by American Journal of Ophthalmology (n = 24) and Albrecht von Graefe's Archiv für Ophthalmologie (n = 9). These articles originated from 14 countries, with the United States publishing the majority (n = 58). Most of the citation classics are clinical studies on topics such as rubella cataract, retinopathy of prematurity, keratoconjunctivitis sicca, sympathetic ophthalmia, and the first report of eponymous diseases (eg, Leber hereditary optic neuropathy, Duane retraction syndrome, and Stargardt disease). A considerable number of these articles were ignored initially and for several decades after publication, but, like the classic fairy tale Sleeping Beauty, they have been rediscovered. Our study provides a historical perspective on the classic papers in the literature that are still influential in ophthalmology.
Thurtell, Matthew J; Chiu, Alison L S; Goold, Lucy A; Akdal, Gulden; Crompton, John L; Ahmed, Rebekah; Madge, Simon N; Selva, Dinesh; Francis, Ian; Ghabrial, Raf; Ananda, Arj; Gibson, John; Chan, Raymond; Thompson, Elizabeth O; Rodriguez, Michael; McCluskey, Peter J; Halmagyi, G Michael
Invasive fungal sinusitis is a rare condition that usually occurs in immunocompromised patients and often presents as an orbital apex syndrome. It is frequently misdiagnosed on presentation and is almost always lethal without early treatment. Retrospective case series of 14 consecutive patients with biopsy-proven invasive fungal sinusitis from four tertiary hospitals. Fourteen patients (10 men and 4 women; age range 46-82 years). Retrospective chart review of all patients presenting with invasive fungal sinusitis between 1994 and 2010 at each hospital, with a close analysis of the tempo of the disease to identify any potential window of opportunity for treatment. Demographic data, background medical history (including predisposing factors), symptoms, signs, radiological findings, histopathological findings, treatment approach and subsequent clinical course were recorded and analysed. Only one patient was correctly diagnosed at presentation. Only two patients were not diabetic or immunocompromised. The tempo was acute in two patients, subacute in nine patients and chronic in three patients. In the subacute and chronic cases, there was about 1 week of opportunity for treatment, from the time there was a complete orbital apex syndrome, and still a chance for saving the patient, to the time there was central nervous system invasion, which was invariably fatal. Only two patients survived - both had orbital exenteration, as well as antifungal drug treatment. Invasive fungal sinusitis can, rarely, occur in healthy individuals and should be suspected as a possible cause of a progressive orbital apex syndrome. © 2012 The Authors. Clinical and Experimental Ophthalmology © 2012 Royal Australian and New Zealand College of Ophthalmologists.
Mozzini, Chiara; Casadei, Alder; Roscia, Giuseppe; Cominacini, Luciano
Cigarette smoking is known as a major risk factor in the pathogenic mechanisms of stroke, coronary and peripheral artery disease (CAD and PAD), even in young subjects. The aim of this study is the creation of a four-step ultrasound examination to evaluate and monitor the peripheral, the extra and the intra-cranial assessment of the arterial early damage in smokers. The evaluations of A, the Ankle-brachial index, ABI, B, the Breath holding index, BHI, C, the Carotid intima media thickness, CIMT, and D, the Diameter of the abdominal aorta represent the "ABCD" assessment. Thirty-eight healthy smokers and 43 controls underwent A, calculated for each leg. B was calculated after determination of subjects' flow velocity of middle cerebral artery (MCA) by trans-cranial colour Doppler (TCCD) before and after 30 s of apnoea at baseline and just after smoking a cigarette, to simulate the chronic and acute effects of smoking. Finally, C and D evaluation were assessed using a high-resolution B-mode ultrasound. Smokers presented higher values of CIMT (mean and maximal), and lower BHI both at baseline and just after smoking (p ABCD" examination could represent a valid method to detect and then monitor smokers' vascular damage. Although it is far to be considered a screening and routine tool, it should be contemplated in a wider context of possible not-invasive practical screening and follow-up modalities. This would be designed to implement preventive strategies and tools aimed at discouraging tobacco addiction and monitoring cardiovascular risk patients.
Gallagher, Michelle; Prinstein, Mitchell J; Simon, Valerie; Spirito, Anthony
Recent research has shown that social anxiety may be related to increased risk for suicidal ideation in teens, although this research largely has been cross-sectional and has not examined potential mediators of this relationship. A clinical sample of 144 early adolescents (72 % female; 12-15 years old) was assessed during psychiatric inpatient hospitalization and followed up at 9 and 18 months post-baseline. Symptoms of social anxiety, depression, suicidal ideation, loneliness, and perceived social support were assessed via structured interviews and self-report instruments. Structural equation modeling revealed a significant direct relationship between social anxiety symptoms at baseline and suicidal ideation at 18 months post-baseline, even after controlling for baseline depressive symptoms and ideation. A second multiple mediation model revealed that baseline social anxiety had a significant indirect effect on suicidal ideation at 18 months post-baseline through loneliness at 9 months post-baseline. Social anxiety did not have a significant indirect effect on suicidal ideation through perceived social support from either parents or close friends. Findings suggest that loneliness may be particularly implicated in the relationship between social anxiety and suicidality in teens. Clinicians should assess and address feelings of loneliness when treating socially anxious adolescents.
Hargrove, Taylor W; Brown, Tyson H
Previous research has documented a relationship between childhood socioeconomic conditions and adult health, but less is known about racial/ethnic differences in this relationship, particularly among men. This study utilizes a life course approach to investigate racial/ethnic differences in the relationships among early and later life socioeconomic circumstances and health in adulthood among men. Panel data from the Health and Retirement Study and growth curve models are used to examine group differences in the relationships among childhood and adult socioeconomic factors and age-trajectories of self-rated health among White, Black and Mexican American men aged 51-77 years (N=4147). Multiple measures of childhood socioeconomic status (SES) predict health in adulthood for White men, while significantly fewer measures of childhood SES predict health for Black and Mexican American men. Moreover, the health consequences of childhood SES diminish with age for Black and Mexican American men. The childhood SES-adult health relationship is largely explained by measures of adult SES for White men. The life course pathways linking childhood SES and adult health differ by race/ethnicity among men. Similar to arguments that the universality of the adult SES-health relationship should not be assumed, results from our study suggest that scholars should not assume that the significance and nature of the association between childhood SES and health in adulthood is similar across race/ethnicity among men.
Prinstein, Mitchell J.; Simon, Valerie; Spirito, Anthony
Recent research has shown that social anxiety may be related to increased risk for suicidal ideation in teens, although this research largely has been cross-sectional and has not examined potential mediators of this relationship. A clinical sample of 144 early adolescents (72 % female; 12–15 years old) was assessed during psychiatric inpatient hospitalization and followed up at 9 and 18 months post-baseline. Symptoms of social anxiety, depression, suicidal ideation, loneliness, and perceived social support were assessed via structured interviews and self-report instruments. Structural equation modeling revealed a significant direct relationship between social anxiety symptoms at baseline and suicidal ideation at 18 months post-baseline, even after controlling for baseline depressive symptoms and ideation. A second multiple mediation model revealed that baseline social anxiety had a significant indirect effect on suicidal ideation at 18 months post-baseline through loneliness at 9 months post-baseline. Social anxiety did not have a significant indirect effect on suicidal ideation through perceived social support from either parents or close friends. Findings suggest that loneliness may be particularly implicated in the relationship between social anxiety and suicidality in teens. Clinicians should assess and address feelings of loneliness when treating socially anxious adolescents. PMID:24390470
Markovic, Andrea; Bowker, Julie C
Research has revealed significant heterogeneity in the group-level peer outcomes associated with anxious-withdrawal, but little is known about possible sources of this heterogeneity during early adolescence. This study of 271 young adolescents (49 % female; M age = 11.54 years) examined whether the concurrent and short-term longitudinal (3 month period) associations between peer-nominated anxious-withdrawn behaviors and three group-level peer outcomes (overt victimization, peer acceptance, popularity) varied as a function of peer-valued characteristics (humor, prosocial behavior, physical attractiveness, athletic ability) and gender, after accounting for the effects of involvement in mutual friendships. Regression analyses revealed that the associations between anxious-withdrawal and peer outcomes were moderated by peer-valued characteristics and, in many cases, gender. For example, anxious-withdrawal was related positively to overt victimization for all adolescents who were high in prosocial behavior. But, anxious-withdrawal was related negatively to popularity for adolescent boys who were high in prosocial behavior and adolescent girls who were low in prosocial behavior. Anxious-withdrawal also predicted increases in acceptance for adolescent girls who were high in humor, but decreases in acceptance for adolescent boys who were high in humor. Several additional moderator effects were found for boys only. The findings highlight the importance of considering the unique constellation of characteristics displayed by anxious-withdrawn young adolescents in studies on peer experiences at the group-level of social complexity.
Umeh, Kanayo; Chadwick, Rebecca
Research suggests that self-efficacy is an important factor in behaviors that facilitate the early-detection of various cancers. In general people with high self-efficacy are more likely to attend cancer screening sessions or perform bodily self-exams. However, there is a paucity of research focusing on testicular cancer and testicular self-examination (TSE). The effect of self-efficacy on TSE remains unclear especially given the relative obscurity of the testicular cancer threat, and appropriate clinical- and self-detection procedures, in the young asymptomatic male population. Thus, the present study tested the interaction of self-efficacy with young men's appraisals of the threat of testicular cancer. The study was based on 2 × 2 × 2 mixed factorial experimental design. Over 100 young asymptomatic men were exposed to a health warning about testicular cancer and randomly assigned to high/low self-efficacy, vulnerability, and severity conditions. High self-efficacy increased motivation to perform TSE given high vulnerability, but damaged attitudes to self-exams given low vulnerability and severity estimates. High self-efficacy also facilitated subsequent TSE. Overall, these findings support preexisting notions of self-efficacy but raise new questions about the moderating effects of threat appraisals.
Kortüm, K; Reznicek, L; Leicht, S; Ulbig, M; Wolf, A
The importance and complexity of clinical trials is continuously increasing, especially in innovative specialties like ophthalmology. Therefore an efficient clinical trial site organisational structure is essential. In modern internet times, this can be accomplished by web-based applications. In total, 3 software applications (Vibe on Prem, Sharepoint and open source software) were evaluated in a clinical trial site in ophthalmology. Assessment criteria were set; they were: reliability, easiness of administration, usability, scheduling, task list, knowledge management, operating costs and worldwide availability. Vibe on Prem customised by the local university met the assessment criteria best. Other applications were not as strong. By introducing a web-based application for administrating and organising an ophthalmological trial site, studies can be conducted in a more efficient and reliable manner. Georg Thieme Verlag KG Stuttgart · New York.
Full Text Available We report a case of a 22-year-old female student nurse who presented to hospital with an acute neuro-ophthalmological syndrome characterized by papilledema, ataxia, ophthalmoplegia and headache after a single first time use of 150 mg medroxyprogesterone intramuscular injection. Clinical, laboratory, radiological and ophthalmological investigations were in keeping with the diagnosis of idiopathic intracranial hypertension but lumbar puncture did not show a raised cerebrospinal fluid pressure suggesting a forme fruste of this entity. Her neuro-ophthalmological clinical features responded well to acetazolamide and diagnostic/ therapeutic lumbar puncture. Full recovery was achieved three months after medroxyprogesterone usage. Health care providers must be aware of this adverse drug reaction.
Motley, W Walker; Golnik, Karl C; Anteby, Irene; Atilla, Huban; Gole, Glen A; Murillo, Claudia; Olitsky, Scott E; Pilling, Rachel F; Reddy, Aravind R; Sharma, Pradeep; Siatkowski, R Michael; Yadarola, Maria B
The Accreditation Council for Graduate Medical Education (ACGME) requires US residency programs to assess ophthalmology residents for competency in 6 core areas. Ophthalmic surgical skills are currently part of the ACGME "Patient Care" competency, although some have advocated for a seventh competency, "Surgical Skills." The Ophthalmology Surgical Competency Assessment Rubric for Strabismus Surgery in Resident Training ( Strabismus) tool was designed to aid in the assessment of surgical skills using procedure specific behavioral anchors. The present study evaluated inter-rater agreement of the Strabismus tool in the assessment of resident performance. Strabismus evaluations of resident surgical strabismus cases were performed by a multinational group of faculty strabismus surgeons. Cronbach α statistical analysis of the completed evaluations revealed high inter-rater agreement, indicating the Strabismus is a reliable tool to facilitate assessment of resident strabismus surgical skills. Copyright © 2016 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.
Full Text Available AIM:To enhance the doctors' ability of disease diagnosis and treatment by using standardized patients in neuro-ophthalmology teaching. METHODS: Graduated students and visiting students accepting neuro-ophthalmology training courses in Department of Ophthalmology during 2014-2016 were enrolled as the research objects. Two groups were randomized allocated and 20 students each group. One group of students was applied standardized patients teaching method and the other group of students was applied traditional teaching method. A questionnaire and exam after the teaching were evaluated. The data were analyzed by SPSS 20.0. RESULTS: The data of questionnaire included content interest improving, satisfaction for teaching, the key points understanding, theory with practice effective linking, future practice instruction. Comparison questionnaire data between two groups were of statistical significance(PPCONCLUSION: Standardized patients teaching method is helpful for students' training on the ability of clinical diagnosis and treatment.
Dotan, Gad; Qureshi, Hanya M; Saraf, Steven S; Darnley-Fisch, Deborah A
To report on the characteristics, accomplishments, and past experiences of current academic ophthalmology department chairs. Cross-sectional study. Setting: A confidential online survey. Total of 111 chairs of US academic ophthalmology departments. Chairs' general characteristics, training/former positions held, academic accomplishments, previous organization/committee involvement, motivation/insight, and overall work satisfaction. Fifty-five chair responses were received (96% male, mean age 57 years, mean term 7 years). The majority were American medical graduates (93%), full professors of ophthalmology (93%), and permanent chairs (96%). All completed their residency in the US and 96% completed a fellowship (25% vitreoretinal surgery, 22% cornea and external disease, and 20% glaucoma). On average, chairs authored 98 peer-reviewed articles, 2 books, and 11 book chapters. They were also significantly involved in peer-reviewed journal literature, serving as editors (20%), associate editors (18%), or editorial board members (60%). The majority of chairs indicated they decided to seek their position late in their career, having already become a full (33%) or associate professor (26%), primarily owing to a desire to build and promote an academic ophthalmology department (61%). Chairs regarded their experience as head of service as most important for their current performance as department heads. Their principal advice to aspiring ophthalmology chairs was to focus on developing skills as a clinician, researcher, and educator ("triple threat"). Overall, academic department chairs are accomplished leaders in ophthalmology and prolific authors with an established academic record. Chairs regarded their previous leadership roles within the department as invaluable to their effectiveness as chair. Copyright © 2017 Elsevier Inc. All rights reserved.
Cordonnier, Monique; Van Nechel, Christian
There are five possible ocular signs or complaints of a life or sight threatening neuro-ophthalmological condition: diplopia, isolated anisocoria, transient visual loss, severe pain in head or neck (with or without photophobia) and oscillopsia/nystagmus. In this review, the ocular signs and symptoms of neuro-ophthalmological emergencies are described together with their practical work-up and the risks associated with missing the diagnosis. Concerning diplopia, the associated signs pointing to a possible threatening condition are emphasized. Six focus points resuming core messages are displayed throughout this review.
Wincewicz, Andrzej; Sulkowska, Mariola; Lieberman, E James; Bakunowicz-Lazarczyk, Alina; Sulkowski, Stanislaw
Adam Zamenhof was greatly influenced by his father, Ludwik Zamenhof, who designed the international language Esperanto. Like his father, he became an ophthalmologist and joined the Esperanto movement. He published in the field of ophthalmology and was soon chosen as head of an ophthalmology department. He subsequently became Chief of the Orthodox Jewish Hospital at Czystem in Warsaw. He was active in the leadership of the Bialystok-Warsaw Chamber of Medical Doctors. He perished in the Nazi Holocaust (Shoah) but all Zamenhof's ideals that Adam served as a doctor and social activist remain still alive.
McClelland, Collin; Van Stavern, Gregory P.; Shepherd, J. Banks; Gordon, Mae; Huecker, Julia
Objective Neuro-imaging studies are frequently ordered to investigate neuro-ophthalmic symptoms. When misused these studies are expensive and time-consuming. This study aimed to describe the type and frequency of neuro-imaging errors in patients referred to an academic neuro-ophthalmology service and to measure how frequently these neuro-imaging studies were re-interpreted. Design Prospective cohort study Participants 84 consecutive patients referred to an academic neuro-ophthalmology practice Methods From November 2009 through July 2010 we prospectively enrolled 84 consecutive new patients who had received a neuro-imaging study in the last 12 months specifically in evaluation of their presenting neuro-ophthalmic symptoms. Participants then underwent a complete neuro-ophthalmic evaluation followed by a review of prior neuro-imaging. Questions regarding appropriateness of the most recent imaging, concordance of radiological interpretation, and re-evaluation of referring diagnoses were answered by the attending physician. Main Outcome Measures 1. The frequency and types of errors committed in the utilization of neuro-imaging. 2. The frequency of re-interpretation of pre-referral neuro-imaging studies following neuro-ophthalmic history and examination. Results Most study participants (84.5%; 71/84) underwent magnetic resonance imaging (MRI) prior to referral; 15.5% (13/84) underwent only computed tomography (CT). The rate of sub-optimal neuro-imaging studies was 38.1% (32/84). The three most common reasons for sub-optimal studies were incomplete area of imaging (34.4%; 11/32), wrong study type (28.1%; 9/32), and poor image quality (21.9%; 7/32). 24 of 84 subjects (28.6%) required additional neuro-imaging. We agreed with the radiology interpretation of the prior neuro-imaging studies in the majority (77.4%; 65/84) of patients. The most common anatomic locations for discordance in interpretation were the intraorbital optic nerve (35%; 7/20) and the brainstem (20%; 4
Wheeler, Stephanie B
To determine whether higher self-esteem and higher academic performance among youth reduce the likelihood of early sexual intercourse and illegal substance use. Using data from waves I-III of the National Longitudinal Study of Adolescent Health, this study used multivariate logistic regression, stratified by gender and controlling for known covariates, to examine relationships between self-esteem and academic performance and youth decision-making, specifically self-reported initiation of sexual intercourse and use of illegal substances. Self-esteem was constructed as an ascending scale of 10 Likert-scaled survey items. Academic performance was assessed using the most recent grades from English, Math, Science, and History. Among virginal adolescents, higher self-esteem at baseline had no effect on sexual debut 1 year later. However, higher self-esteem at baseline among females corresponded with a significantly lower likelihood of illegal substance use 1 year later (OR, .96; p = .003). In terms of academic performance at baseline, girls averaging "A" grades as compared with girls averaging "C" grades or lower were significantly less likely to initiate sexual intercourse 1 year later (OR, .52; p = .004). Additionally among girls, being an "A" student or a "B" student was associated with lower odds of illegal substance use, compared with students who averaged "C" grades or lower (p self-esteem and academic performance were not significantly predictive of illegal substance use. This study suggests that bolstering self-esteem and improving academic performance among young girls may have specific benefits in sexual decision-making and substance-related risk-taking. Copyright © 2010 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
Full Text Available The paper deals with a metallographic examination of a sword from grave No. 438, which was uncovered at the site of Mikulčice (Hodonín county, a former early medieval stronghold in Moravia (Czech Republic. Mikulčice was one of the main power centres of the Great Moravia – the first state formed by Slavs north of the Danube River – which was created in the first third of the 9th century and ended at the beginning of the 10th century. The sword, provided with a single flattened hemispherical pommel (Petersen X type, has a blade bearing an inscription that is no longer legible. According to the results of metallographic examination, the blade was hardened and consists of steel cutting edges welded on a core, which was composed of steel side-plates and a middle strip of iron or low-carbon steel. It was an excellent sword, undoubtedly one of the best swords excavated in Mikulčice.
El artículo trata de un examen metalográfico de una espada de la tumba número 438, que fue descubierta en el yacimiento de Mikulčice (Hodonín Condado, antiguo bastión bajomedieval en Moravia (República Checa. Mikulčice fue uno de los centros de poder principales del Gran Moravia - la primera agrupación estatal de los eslavos del norte del río Danubio - que se creó en el primer tercio del siglo IX y fue abolido al comienzo del siglo X. La espada, que cuenta con un pomo aplanado hemiesféri-co (Petersen tipo X, tiene una hoja con una inscripción que ya no es legible. De acuerdo con los resulta-dos del examen metalográfico, la hoja fue endurecida y se compone de filos de corte de acero, soldados a un núcleo. Éste está compuesto de placas laterales de acero y una franja central de hierro o de acero dulce. Era una espada excelente, sin duda, una de las mejores espadas jamás excavadas en Mikulčice.
Lo, Ya-yu; Chuang Wang; Haskell, Sherry
This study investigated the effects of the "Scott Foresman Early Reading Intervention" (ERI) on growth rates in the early literacy skills of urban at-risk kindergarten students. Students participated in one of three groups: treatment-intensive/ strategic, treatment-benchmark, and nontreatment-benchmark. Treatment group students received…
La Paro, Karen M.; Thomason, Amy C.; Lower, Joanna K.; Kintner-Duffy, Victoria L.; Cassidy, Deborah J.
The field of early childhood education continues to grapple with the issue of understanding quality in classrooms. The lack of clarity in definition (or conceptualization) and related ability to assess (or operationalize) quality has contributed to a reliance on the Early Childhood Environment Rating Scale (ECERS-R), which is often interpreted to…
Reem, Rachel E.; Van Balen, Joany; Hoet, Armando E.; Cebulla, Colleen M.
Purpose To screen environmental surfaces of an outpatient ophthalmic clinic for methicillin-susceptible and methicillin-resistant Staphylococcus aureus (MSSA and MRSA); to identify the most commonly contaminated surfaces; and to phenotype and genotype all collected isolates Design A single institution, one-year prospective environmental study Methods Commonly touched surfaces from examination rooms and common areas were targeted and sampled on a quarterly basis for one year. Samples were collected using electrostatic cloths and swabs. S. aureus was isolated using non-selective and selective media. Morphological characteristics and standard biological testing were used to confirm staphylococcal species. S. aureus isolates were phenotypically (Kirby-Bauer method) and genotypically characterized (mecA confirmation, SCCmec typing and pulsed-field gel electrophoresis). Dendrogram analysis was used to establish genetic relatedness between the isolates. Results Of 112 total samples, 27 (24%) and 5 (4%) were MSSA- and MRSA-positive, respectively. Both community-associated (SCCmec IV, USA300) and hospital-associated (SCCmec II, USA100) MRSA isolates were found. No single surface remained consistently positive with the same isolate over time and molecular analysis demonstrated high levels of diversity among isolates. Doorknobs, slit-lamp head/chinrests, and computer keyboards were frequently contaminated. Conclusions The proposed surveillance protocol successfully allowed the detection of both MSSA and MRSA contaminating important high-touch surfaces in a representative ophthalmology clinic. Frequently contaminated surfaces must be targeted for routine cleaning and disinfection as a there is a constant introduction of clones over time. Hence, other clinics may consider implementing and adapting surveillance tools, as the one here described, to help them control these important nosocomial pathogens. PMID:24412125
Davis, Alexander S; Elkeeb, Ahmed M; Vizzeri, Gianmarco; Godley, Bernard F
Improvement in clinic efficiency in the ambulatory setting is often looked at as an area for development of lean management strategies to deliver a higher quality of healthcare while reducing errors, costs, and delays. To examine the benefits of improving team communication and its impact on clinic flow and efficiency, we describe a time-motion study performed in an academic outpatient Ophthalmology clinic and its objective and subjective results. Compared to clinic encounters without the use of the portable radios, objective data demonstrated an overall significant decreases in mean workup time (15.18 vs. 13.10), room wait (13.10 vs. 10.47), and decreased the total time needed with an MD per encounter (9.45 vs. 6.63). Subjectively, significant improvements were seen in careprovider scores for patient flow (60.78 vs. 84.29), getting assistance (61.89 vs. 88.57), moving patient charts (54.44 vs. 85.71), teamwork (69.56 vs. 91.0), communications (62.33 vs. 90.43), providing quality patient care (76.22 vs. 89.57), and receiving input on the ability to see walk-in patients (80.11 vs. 90.43). For academic purposes, an improvement in engagement in patient care and learning opportunities was noted by the clinic resident-in-training during the pilot study. Portable radios in our pilot study were preferred over the previous method of communication and demonstrates significant improvements in certain areas of clinical efficiency, subjective perception of teamwork and communications, and academic learning.
Lippa, Linda Mottow; Anderson, Craig L
To explore the impact of online learning and multisensory small-group teaching on acquisition and retention of specialty knowledge and diagnostic skills during a third-year family medicine rotation. Exploratory, observational, longitudinal, and multiple-skill measures. Two medical school classes (n = 199) at a public medical school in California. Students engaged in online self-study, small-group interactive diagnostic sessions, picture identification of critical pathologic features, and funduscopic simulator examinations. The authors compared performance on testing immediately after online learning with testing at end-rotation, as well as picture identification versus simulator diagnostic ability in students with (n = 94) and without (n = 105) practice tracing contours on whiteboard projections of those same slides depicting fundus pathologic features of common systemic diseases. Picture identification, accuracy of funduscopic descriptions, online module post-tests, and end-rotation tests. Proprioceptive reinforcement of fundus pattern recognition significantly reduced the need for remediation for misdiagnosing optic disc edema during end-rotation funduscopic simulator testing, but it had no effect on fundus pattern recognition or diagnostic ability overall. Near-perfect immediate online post-test scores contrasted sharply with poor end-rotation scores on an in-house test (average, 59.4%). Rotation timing was not a factor because the patterns remained consistent throughout the academic school year. Neither multisensory teaching nor online self-study significantly improved retention of ophthalmic knowledge and diagnostic skills by the end of a month-long third-year rotation. Timing such training closer to internship when application is imminent may enhance students' appreciation for its value and perhaps may improve retention. Pulsed quizzes over time also may be necessary to motivate students to retain the knowledge gained. Copyright © 2015 American Academy of
Ibadan in 1972 when I was a neophyte clinical student on ward E1. Professor EO Olurin was the generalissimo. ... Osuntokun of blessed memory, and his able lieutenant,. Professor O Bademosi. At that early stage in medical ... They offer useful nursing care and act as continuous monitors of the patient's well being. Some.
Full Text Available Aim: To evaluate teaching and practice in medical college ophthalmology departments in a representative Indian state and changes following provision of modern instrumentation and training. Study Type: Prospective qualitative study. Materials and Methods: Teaching and practice in all medical colleges in the state assessed on two separate occasions by external evaluators. Preferred criteria for training and care were pre-specified. Methodology included site visits to document functioning and conduct interviews. Assessments included resident teaching, use of instrumentation provided specifically for training and standard of eye care. The first evaluation (1998 was followed by provision of modern instrumentation and training on two separate occasions, estimated at Rupees 34 crores. The follow-up evaluation in 2006 used the same methodology as the first. Results: Eight departments were evaluated on the first occasion; there were 11 at the second. On the first assessment, none of the programs met the criteria for training or care. Following the provision of modern instrumentation and training, intraocular lens usage increased dramatically; but the overall situation remained essentially unchanged in the 8 departments evaluated 8 years later. Routine comprehensive eye examination was neither taught nor practiced. Individually supervised surgical training using beam splitters was not practiced in any program; neither was modern management of complications or its teaching. Phacoemulsification was not taught, and residents were not confident of setting up practice. Instruments provided specifically for training were not used for that purpose. Students reported that theoretical teaching was good. Conclusions: Drastic changes in training, patient care and accountability are needed in most medical college ophthalmology departments.
Strasser, Torsten; Peters, Tobias; Jägle, Herbert; Zrenner, Eberhart
The ISCEV standards and recommendations for electrophysiological recordings in ophthalmology define a set of protocols with stimulus parameters, acquisition settings, and recording conditions, to unify the data and enable comparability of results across centers. Up to now, however, there are no standards to define the storage and exchange of such electrophysiological recordings. The aim of this study was to develop an open standard data format for the exchange and storage of visual electrophysiological data (ElVisML). We first surveyed existing data formats for biomedical signals and examined their suitability for electrophysiological data in ophthalmology. We then compared the suitability of text-based and binary formats, as well as encoding in Extensible Markup Language (XML) and character/comma-separated values. The results of the methodological consideration led to the development of ElVisML with an XML-encoded text-based format. This allows referential integrity, extensibility, the storing of accompanying units, as well as ensuring confidentiality and integrity of the data. A visualization of ElVisML documents (ElVisWeb) has additionally been developed, which facilitates the exchange of recordings on mailing lists and allows open access to data along with published articles. The open data format ElVisML ensures the quality, validity, and integrity of electrophysiological data transmission and storage as well as providing manufacturer-independent access and long-term archiving in a future-proof format. Standardization of the format of such neurophysiology data would promote the development of new techniques and open software for the use of neurophysiological data in both clinic and research.
Singman, Eric L; Haberman, Chantal V; Appelbaum, Jeffrey; Tian, Jing; Shafer, Karen; Toerper, Matthew; Katz, Susanne; Kelsay, Maureen; Boland, Michael V; Greenbaum, Milton; Adelman, Rebecca; Thomas, Richard C; Vakili, Sharif
Real-time location systems (RTLS) and Lean management approaches have been employed to improve patient flow in clinical settings. This study explored the feasibility of using these methodologies in an outpatient resident ophthalmology clinic. Patients, providers, and staff in Wilmer Eye Institute General Eye Services Clinic were provided RTLS tags to track their movement throughout the clinic after observational studies modeling flow were conducted. Tracking data guided changes for clinic processes based on Lean management approaches, including reorganization of the reception desk, consolidation of forms, creation of task sheets to improve communication, installation of door flags on examination rooms, and training the staff in service excellence. Tracking was repeated after changes were implemented. A patient satisfaction survey was also conducted prior to and after the changes. After intervention, significant increases were measured in the average time patients spent in the clinic (99.3 minutes vs 112.8 minutes). Significant decreases were seen in the times patients spent with the optometrists (15.4 minutes vs 12.1 minutes), testing (24.7 minutes vs 23.0 minutes), and together with both the attending and the resident (8.3 minutes vs 5.8 minutes). The patient satisfaction survey indicated improvements in patients' perception of the helpfulness/friendliness of the staff, the length of time patients perceived they waited, and overall clinic experience. Both RTLS and Lean management approaches may be feasible ways to track and improve patient flow and satisfaction if certain limitations can be overcome. This is the first published report describing these approaches applied to an academic ophthalmology clinic in the United States.
Full Text Available Objective. There are few data from before the antiretroviral therapy (ART era for cytomegalovirus retinitis (CMV-R from settings where cost limits use of systemic treatment. This study examines CMV-R treatment and survival outcomes in a public hospital ophthalmology service in Ga-Rankuwa, South Africa. Methods. From October 2009 to October 2010, voluntarily consenting participants over the age of 15 years with incident clinically diagnosed CMV-R seen at the Dr George Mukhari Hospital ophthalmology clinic were prospectively enrolled in an observational study. Treatment was per clinic protocols and patients were followed up with structured data collection for up to 6 months. Results. Eight individuals, all HIV infected and 50% female, were identified and enrolled. At enrolment, median age was 38 years (interquartile range (IQR 32 - 39 years, median CD4 count 20 cells/μl (IQR 13 - 46.5 cells/μl, and 50% were currently receiving ART (mean duration of ART use 18 days, standard deviation (SD 2.99 days. No participant received systemic ganciclovir, but 6 reported symptom combinations suggesting systemic CMV: shortness of breath (n=3, diarrhoea (n=3 and/or central nervous system complaints (n=3. Ten eyes had visual impairment less than counting fingers at enrolment. Treatment combinations were: ART plus intravitreal ganciclovir (n=5, intravitreal ganciclovir alone (n=2, and ART alone (n=1. Six-month outcomes were: death (n=1, survival (n=6, loss to follow-up (n=3, untraceable (n=1, systemic symptom resolution (4/4, visual acuity deterioration (0/5, and persisting uveitis (2/3. Conclusion. In the ART era, incident CMV-R appears to be uncommon in this setting. CMV-R may occur within the first 3 weeks after ART initiation. Even in CMV-R patients with suggestive systemic symptoms, 6-month survival is good despite no systemic CMV therapy. S Afr J HIV Med 2012;13(2:68-71.
Full Text Available Kyle MacLean,1 Holly B Hindman2,3 1University of Rochester School of Medicine and Dentistry, Rochester, NY, USA; 2The Flaum Eye Institute, University of Rochester, Rochester, NY, USA; 3Center for Visual Science, University of Rochester, Rochester, NY, USA Purpose: To assess medical student ophthalmic educational exposure and service provided through the University of Rochester’s UR Well Eye Care (URWEC program, a student-run initiative in which medical students provide supervised eye care to an uninsured urban population.Design: Retrospective chart review.Subjects: Consecutive patients seen at the student-run URWEC in Rochester, NY, USA between June 2008 and June 2013.Methods: One hundred and forty-five of 148 charts of consecutive patients seen at URWEC over the 5-year period were identified and reviewed. Data on patient demographics, reason for visit, history, examination, diagnoses, and management were collected into a database. Main outcome measures: Main outcome measures included reasons for referral, student performance of ophthalmic examination components, ophthalmic diagnoses, and hours of volunteer service rendered. Results: Patients came from a variety of countries and educational and racial backgrounds. The most common reason for referral to URWEC was diabetic screening eye exams (66/145, 46%. Student volunteers performed the following examination components in 79%–100% of visits under direct supervision of an attending ophthalmologist: visual acuity, pupils, extraocular movements, confrontation visual fields, intraocular pressure, drop administration, slit-lamp examination, and dilated fundoscopic exam. The most common diagnosis other than refractive error was cataract (29/145, 20%. Almost half of patients (66/145, 46% were diagnosed with potentially vision-threatening conditions. Six hundred and thirty hours of community service were rendered by students and attending ophthalmologists during the 5-year period
Hollander, A.I. den; Lith-Verhoeven, J.J. van; Arends, M.L.; Strom, T.M.; Cremers, F.P.M.; Hoyng, C.B.
OBJECTIVE: To describe the clinical characteristics and determine the genetic defect in a Surinamese family with autosomal recessive retinitis pigmentosa. METHODS: Family members underwent blood sampling and ophthalmologic examinations. After exclusion of all known mutations in all genes involved in
Lifestyle-related diseases cause macro-and microangiopathies in the major organs including the brain, heart, kidney, and eye, and as a result, shorten the lifespan. The renin-angiotensin system (RAS) has recently been shown to contribute to the processes of accelerated aging caused by lifestyle-related diseases from visceral obesity in the early stage to late-onset organ damage. Vision-threatening diabetic retinopathy and age-related macular degeneration (AMD), associated with lifestyle-related diseases as risk factors for progression, develop retinal and choroidal neovascularization (CNV), respectively, in their advanced stages. We have found that tissue RAS is activated in the pathogenesis of diabetic retinopathy and CNV, leading to angiotensin type 1 receptor(AT1-R)-mediated expression of inflammation-related molecules including vascular endothelial growth factor (VEGF), intercellular adhesion molecule (ICAM)-1, and monocyte chemotactic protein(MCP)-1. Neuronal dysfunction in diabetic retinopathy is also shown to result from AT1-R-mediated degradation of synaptic proteins. Moreover, we revealed for the first time that the receptor for prorenin [(pro) renin receptor] is expressed in the eye, although prorenin was until recently believed to be just an inactive precursor of renin. Prorenin binds to the receptor that causes dual activation of its intracellular signaling and tissue RAS, and this pathogenic mechanism is termed receptor-associated prorenin system (RAPS)'. We have demonstrated the contribution of RAPS to the pathogenesis of CNV and dual regulation of VEGF and MCP-1 by signal transduction via (pro) renin receptor and AT1-R. Next, we report the potential validity of food factor supplements as a therapeutic strategy for preventing the retinal and choroidal pathologies driven by RAS-induced inflammatory and angiogenic molecules. Functional food factors examined include lutein in yellow-green vegetables, the omega-3 polyunsaturated fatty acid
Kortüm, K U; Müller, M; Babenko, A; Kampik, A; Kreutzer, T C
In times of increased digitalization in healthcare, departments of ophthalmology are faced with the challenge of introducing electronic clinical health records (EHR); however, specialized software for ophthalmology is not available with most major EHR sytems. The aim of this project was to create specific ophthalmological user interfaces for large inpatient eye care providers within a hospitalwide EHR. Additionally the integration of ophthalmic imaging systems, scheduling and surgical documentation should be achieved. The existing EHR i.s.h.med (Siemens, Germany) was modified using advanced business application programming (ABAP) language to create specific ophthalmological user interfaces for reproduction and moreover optimization of the clinical workflow. A user interface for documentation of ambulatory patients with eight tabs was designed. From June 2013 to October 2014 a total of 61,551 patient contact details were documented. For surgical documentation a separate user interface was set up. Digital clinical orders for documentation of registration and scheduling of operations user interfaces were also set up. A direct integration of ophthalmic imaging modalities could be established. An ophthalmologist-orientated EHR for outpatient and surgical documentation for inpatient clinics was created and successfully implemented. By incorporation of imaging procedures the foundation of future smart/big data analyses was created.
Background Few studies have evaluated satisfaction with medical residency programs from the perspective of residents or recent graduates. Knowledge of current conditions of teaching might help to identify deficiencies and to provide adequate training. So, the aim of this study was to assess the satisfaction with residency training and to identify deficiencies in this training from the perspective of recent graduates in ophthalmology residency. Methods For this purpose, we developed a questionnaire and gaved it to recent graduates in ophthalmology residency in São Paulo, Brazil, from January to December 2010. The questions contained demographic information (age, sex and time of practice in ophthalmology), a Likert scale to evaluate the level of satisfaction with medical residency concerning clinical knowledge, surgical skills and doctor-patient relationship and questions about deficiency in clinical and surgical areas. Results The areas in which recent residency graduates were very or extremely satisfied were: acquisition of clinical knowledge (89.1%), acquisition of surgical skills (93.4%) and the development of doctor-patient relationship (74.9%). Specific areas of clinical knowledge in which they perceived more deficiency were orbit (48.3%) and ophthalmic pathology (47.9%), and in surgical skills were refractive surgery (65.9%) and orbit (59.2%) Conclusions The assessment of the satisfaction with residency training in ophthalmology from the perspective of recent graduates showed high level of satisfaction and identified specific deficiencies in ophthalmic pathology, refractive surgery and orbit. PMID:23706136
Kuo, Irene C
Major academic ophthalmology departments have been expanding by opening multi-office locations ("satellites"). This paper offers a first glimpse into satellites of academic ophthalmology departments. Leaders of seven medium to large, geographically diverse departments agreed to participate. One- to two-hour phone interviews were conducted to assess the features of their satellite practices. Success as clinical entities, profitability, and access to patients were stated goals for most satellites. In approximate descending order, refractive surgery, retina, oculoplastics, and pediatric ophthalmology were the most common subspecialties offered. Faculty staffing ranged from recruitment specifically for satellites to rotation of existing faculty. Except for a department with only one academic track, satellite doctors were a mix of tenure and mostly non-tenure track faculty. According to these department leaders, scholarly productivity of satellite faculty was similar to that of colleagues at the main campus, though research was more community-based and clinical in nature. Fellowship but little resident education occurred at satellites. Though it was agreed that satellite practices were integral to department finances, they accounted for a smaller percentage of revenues than of total departmental visits. Satellite offices have offered access to a better payor mix and have boosted the finances of academic ophthalmology departments. Challenges include maintaining collegiality with referring community physicians, integrating faculty despite geographic distance, preserving the department's academic "brand name," and ensuring consistent standards and operating procedures. Satellite clinics will likely help departments meet some of the challenges of health care reform.
Neuro-ophthalmology focuses on the diagnosis and treatment of visual disorders related to the neurological system rather than the globe itself. Being a subspecialty of both neurology and ophthalmology, it requires specialized training and expertise in diseases of the eye, brain, nerves and muscles. Commonly encountered pathologies in neuro-ophthalmology include: optic neuropathies (such as optic neuritis and ischemic optic neuropathy), visual field loss (transient, constant, unexplained), transient visual loss, unspecified visual disturbances, diplopia, abnormal eye movements, thyroid eye disease, myasthenia gravis, anisocoria, and eyelid abnormalities. The current issue of "Harefuah" is dedicated to contemporary knowledge in neuro-opthalmology, and spans from studies of neuromyelitis optica (NMO), ischemic optic neuropathies, and optic neuropathies induced by phosphodiesterase inhibitors, to the management of sight-threatening carotid-cavernous fistulas, and more. These studies emphasize the importance of an interdisciplinary treatment team consisting of a neuro-ophthalmologist, a neuro-radiologist, and sometimes, even a neuro-surgeon. Such an approach may prove to be beneficial to the patient, by optimizing follow-up and treatment decisions. This issue emphasizes how a correct and timely diagnosis is of paramount significance in patients with neuro-ophthalmological disorders.
Holtmann, H W; Stein, H J
The potentiated general anaesthesia with ethyl urethane and propionylpromazine for long-time ophthalmological experiments on rabbits is not adequate. It is suggested to apply additional ketamin (i.v. and i.m.). With this procedure a satisfactory position of rest is obtained for more than two hours.
Prince, Arlene Leinbach; And Others
A study of instructional materials, especially media, available for ophthalmology teaching was initiated at the University of Washington School of Medicine in March 1973. Some 115 catalog and distribution sources were contracted, from which more than 200 potential titles were identified. Fifty three materials were reviewed and evaluated. Six…
... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration Food and Drug Administration/American Academy of Ophthalmology Workshop on Developing Novel Endpoints for Premium Intraocular Lenses; Public Workshop AGENCY: Food and Drug Administration, HHS. ACTION: Notice...
... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration Food and Drug Administration/American Academy of Ophthalmology Workshop on Developing Novel Endpoints for Premium Intraocular Lenses; Public Workshop AGENCY: Food and Drug Administration, HHS. ACTION: Notice....
Vagge, Aldo; Gunton, Kammi; Schnall, Bruce
To investigate the effectiveness of an eye muscle surgery course on first- and second-year postgraduate ophthalmology residents. This prospective cohort pilot study invited first- and second-year ophthalmology residents to participate in a 2-hour strabismus surgery course at Wills Eye Hospital. The course consisted of a didactic session followed by a wet laboratory session. The wet laboratory session simulated strabismus surgery using a model constructed of chicken breast followed by partial-thickness scleral suture passes in pig eyes. A structured self-assessment evaluation form and a questionnaire in the validated Ophthalmology Surgical Competency Assessment Rubric approved by the International Council of Ophthalmology (ICO-OSCAR:strabismus) were used to assess the effectiveness of the course. A total of 12 residents, 8 (67%) first-year and 4 (33%) second-year, were enrolled for this survey. Following the course, most residents felt less anxious (73%). All residents responded that the course was helpful or somewhat helpful in preparation for strabismus surgery. Regarding the distribution of ratings on questions of subjective experience, knowledge of steps, and understanding of potential complications, the residents gave significantly higher ratings after the course (P < .029). The change in the modified ICO-OSCAR:strabismus assessment's mean score was statistically significant before and after training (P = .038). A strabismus course can play an important role in preparing residents for strabismus surgery. [J Pediatr Ophthalmol Strabismus. 2017;54(6):339-345.]. Copyright 2017, SLACK Incorporated.
This study was carried out to evaluate the value of trypan blue dye in the training of resident doctors in ophthalmology to perform capsulotomy, on important step in cataract extraction. Eight resident were randomized into 2 groups of 4 each. One group used trypan blue while the other group did not. In the trypan blue group, ...
Steedman, Michael; Abouammoh, Marwan; Sharma, Sanjay
To evaluate the effectiveness of a novel multimedia learning tool (MMLT) for teaching a method of approaching common ophthalmologic presentations. Randomized clinical study. 25 second-year medical students at Queen's University. We evaluated 2 MMLTs pertaining to common ophthalmologic presentations--acute visual loss and cataract--through the use of a randomized clinical study. Subjects were randomized either to watch a short-form video or to read a textbook excerpt for both cataract and acute visual loss. If randomized to one MMLT for the first module, the subject was allocated to the other modality for the second module. The main outcomes of interest were knowledge retention as measured by a short multiple-choice questionnaire, efficiency, and user preference. A trend was noted whereby subjects randomized to an MMLT had higher composite scores on multiple-choice questionnaires (mean score MMLT = 75.2% vs text = 67.5%; t test = 1.535; df = 22; p value = 0.139). Additionally, those who watched an MMLT spent 72% less time reviewing the education content (29 min vs 8 min; t test = 3.955, p value = 0.0003). Of the sample, 87% preferred the MMLT over the text. MMLTs can significantly reduce learning time without sacrificing knowledge retention in undergraduate students of ophthalmology. Copyright © 2012 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.
Steenen, Serge A.; Dubois, Leander; Saeed, Peerooz; de Lange, Jan
Intraoral administration of local anesthetics is one of the most common dental procedures. Ophthalmologic complications can occur after maxillary as well as mandibular local anesthetic injections and may be underreported and sometimes misinterpreted. A review of the literature from the years
Naunheim, Matthew R; Kozin, Elliot D; Sethi, Rosh K; Ota, H G; Gray, Stacey T; Shrime, Mark G
Specialty emergency departments (EDs) provide a unique mechanism of health care delivery, but the value that they add to the medical system is not known. Evaluation of patient preferences to determine value can have a direct impact on resource allocation and direct-to-specialist care. To assess the feasibility of contingent valuation (CV) methodology using a willingness-to-pay (WTP) survey to evaluate specialty emergency services, in the context of an ophthalmology- and otolaryngology-specific ED. Contingent valuation analysis of a standalone otolaryngology and ophthalmology ED. Participants were English-speaking adults presenting to a dedicated otolaryngology and ophthalmology ED. The WTP questions were assessed using a payment card format, with reference to an alternative modality of treatment (ie, general ED), and were analyzed with multivariate regression. Validated WTP survey administered from October 14, 2014, through October 1, 2015. Sociodemographic data, level of distress, referral data, income, and WTP. A total of 327 of 423 (77.3%) ED patients responded to the WTP survey, with 116 ophthalmology and 211 otolaryngology patients included (52.3% female; mean [range] age, 46 [18-90] years). The most common reason for seeking care at this facility was a reputation for specialty care for both ear, nose, and throat (80 [37.9%]) and ophthalmology (43 [37.1%]). Mean WTP for specialty-specific ED services was $377 for ophthalmology patients, and $321 for otolaryngology patients ($340 overall; 95% CI, $294 to $386), without significant difference between groups (absolute difference, $56; 95% CI, $-156 to $43). Self-reported level of distress was higher among ear, nose, and throat vs ophthalmology patients (absolute difference, 0.47 on a Likert scale of 1-7; 95% CI, 0.10 to 0.84). Neither level of distress, income, nor demographic characteristics influenced WTP, but patients with higher estimates of total visit cost were more likely to have higher WTP (β coefficient
Gheorghe, Consuela-Mădălina; Gheorghe, Iuliana-Raluca; Purcărea, Victor Lorin
Introduction. The importance of experience in marketing grew, as the concept itself is very personal and difficult to measure. Experience turns out to be complicated but once placed in a context it gets significant features. As the health care competitive environment increases, marketers are looking for new and effective methods of engaging consumers by using experiential marketing strategies. Moreover, little is known about the consumers’ perceptions related to ophthalmologic services. Aim. The objective of this paper was to measure the consumer’s perception of experiential marketing in the Romanian private ophthalmologic services by using structural equation modeling. Materials and Methods. The Experiential Marketing model consisted of the following components: Sense Experience, Feel Experience, Think Experience, Act Experience and Relate Experience as well as the consequences of applying Experiential Marketing in the form of willingness to purchase a service, generating word-of-mouth communication and building consumer loyalty. The sampling method was non-probabilistic, using the snowball technique and the sample was made up of 190 people who wore eyeglasses for more than 3 years. The instrument for data collection was a self-administered questionnaire, which consisted of 2 parts: the first section contained several demographic questions and the second section encompassed closed end questions related to the perception of private ophthalmologic services from an experiential marketing perspective. All the second section questions were measured on a 5-point Likert scale ranging from 1 with Strongly Disagree to 5 to Strongly Agree. The data analysis was conducted in SPSS and the structural equation modeling was performed in WarpPLS version 6.0. Findings. There were 71.05% respondents, who appreciated the application of experiential marketing in private ophthalmologic services, followed by 18.95%, who were confused. The demographic profile of respondents
Gheorghe, Consuela-Mădălina; Gheorghe, Iuliana-Raluca; Purcărea, Victor Lorin
Introduction. The importance of experience in marketing grew, as the concept itself is very personal and difficult to measure. Experience turns out to be complicated but once placed in a context it gets significant features. As the health care competitive environment increases, marketers are looking for new and effective methods of engaging consumers by using experiential marketing strategies. Moreover, little is known about the consumers' perceptions related to ophthalmologic services. Aim. The objective of this paper was to measure the consumer's perception of experiential marketing in the Romanian private ophthalmologic services by using structural equation modeling. Materials and Methods. The Experiential Marketing model consisted of the following components: Sense Experience, Feel Experience, Think Experience, Act Experience and Relate Experience as well as the consequences of applying Experiential Marketing in the form of willingness to purchase a service, generating word-of-mouth communication and building consumer loyalty. The sampling method was non-probabilistic, using the snowball technique and the sample was made up of 190 people who wore eyeglasses for more than 3 years. The instrument for data collection was a self-administered questionnaire, which consisted of 2 parts: the first section contained several demographic questions and the second section encompassed closed end questions related to the perception of private ophthalmologic services from an experiential marketing perspective. All the second section questions were measured on a 5-point Likert scale ranging from 1 with Strongly Disagree to 5 to Strongly Agree. The data analysis was conducted in SPSS and the structural equation modeling was performed in WarpPLS version 6.0. Findings. There were 71.05% respondents, who appreciated the application of experiential marketing in private ophthalmologic services, followed by 18.95%, who were confused. The demographic profile of respondents encompassed
Robinson, June K; Gaber, Rikki; Hultgren, Brittney; Eilers, Steven; Blatt, Hanz; Stapleton, Jerod; Mallett, Kimberly; Turrisi, Rob; Duffecy, Jenna; Begale, Mark; Martini, Mary; Bilimoria, Karl; Wayne, Jeffrey
Early detection of melanoma improves survival. Since many melanoma patients and their spouses seek the care of a physician after discovering their melanoma, an ongoing study will determine the efficacy of teaching at-risk melanoma patients and their skin check partner how to conduct skin self-examinations (SSEs). Internet-based health behavior interventions have proven efficacious in creating behavior change in patients to better prevent, detect, or cope with their health issues. The efficacy of electronic interactive SSE educational intervention provided on a tablet device has not previously been determined. The electronic interactive educational intervention was created to develop a scalable, effective intervention to enhance performance and accuracy of SSE among those at-risk to develop melanoma. The intervention in the office was conducted using one of the following three methods: (1) in-person through a facilitator, (2) with a paper workbook, or (3) with a tablet device used in the clinical office. Differences related to method of delivery were elucidated by having the melanoma patient and their skin check partner provide a self-report of their confidence in performing SSE and take a knowledge-based test immediately after receiving the intervention. The three interventions used 9 of the 26 behavioral change techniques defined by Abraham and Michie to promote planning of monthly SSE, encourage performing SSE, and reinforce self-efficacy by praising correct responses to knowledge-based decision making and offering helpful suggestions to improve performance. In creating the electronic interactive SSE educational intervention, the educational content was taken directly from both the scripted in-person presentation delivered with Microsoft PowerPoint by a trained facilitator and the paper workbook training arms of the study. Enrollment totaled 500 pairs (melanoma patient and their SSE partner) with randomization of 165 pairs to the in-person, 165 pairs to the
Bowen, Randy C; Koeppel, Jan N; Christensen, Chance D; Snow, Karisa B; Ma, Junjie; Katz, Bradley J; Krauss, Howard R; Landau, Klara; Warner, Judith E A; Crum, Alison V; Straumann, Dominik; Digre, Kathleen B
Eye pain is a common complaint, but no previous studies have determined the most common causes of this presenting symptom. Our objective was to determine the most common causes of eye pain in 2 ophthalmology and neurology departments at academic medical centers. This was a retrospective cross-sectional analysis and chart review at the departments of ophthalmology and neurology at the University Hospital Zurich (USZ), University of Zürich, Switzerland, and the University of Utah (UU), USA. Data were analyzed from January 2012 to December 2013. We included patients aged 18 years or older presenting with eye pain as a major complaint. Two thousand six hundred three patient charts met inclusion criteria; 742 were included from USZ and 1,861 were included from UU. Of these, 2,407 had been seen in an ophthalmology clinic and 196 had been seen in a neurology clinic. Inflammatory eye disease (conjunctivitis, blepharitis, keratitis, uveitis, dry eye, chalazion, and scleritis) was the underlying cause of eye pain in 1,801 (69.1%) of all patients analyzed. Although only 71 (3%) of 2,407 patients had migraine diagnosed in an ophthalmology clinic as the cause of eye pain, migraine was the predominant cause of eye pain in the neurology clinics (100/196; 51%). Other causes of eye pain in the neurology clinics included optic neuritis (44 patients), trigeminal neuralgia, and other cranial nerve disorders (8 patients). Eye pain may be associated with a number of different causes, some benign and others sight- or life-threatening. Because patients with eye pain may present to either a neurology or an ophthalmology clinic and because the causes of eye pain may be primarily ophthalmic or neurologic, the diagnosis and management of these patients often requires collaboration and consultation between the 2 specialties.
Background Dental caries (decay) during childhood is largely preventable however it remains a significant and costly public health concern, identified as the most prevalent chronic disease of childhood. Caries in children aged less than five years (early childhood caries) is a rapid and progressive disease that can be painful and debilitating, and significantly increases the likelihood of poor child growth, development and social outcomes. Early childhood caries may also result in a substantial social burden on families and significant costs to the public health system. A disproportionate burden of disease is also experienced by disadvantaged populations. Methods/Design This study involves the establishment of a birth cohort in disadvantaged communities in Victoria, Australia. Children will be followed for at least 18 months and the data gathered will explore longitudinal relationships and generate new evidence on the natural history of early childhood caries, the prevalence of the disease and relative contributions of risk and protective biological, environmental and behavioural factors. Specifically, the study aims to: 1. Describe the natural history of early childhood caries (at ages 1, 6, 12 and 18 months), tracking pathways from early bacterial colonisation, through non-cavitated enamel white spot lesions to cavitated lesions extending into dentine. 2. Enumerate oral bacterial species in the saliva of infants and their primary care giver. 3. Identify the strength of concurrent associations between early childhood caries and putative risk and protective factors, including biological (eg microbiota, saliva), environmental (fluoride exposure) and socio-behavioural factors (proximal factors such as: feeding practices and oral hygiene; and distal factors such as parental health behaviours, physical health, coping and broader socio-economic conditions). 4. Quantify the longitudinal relationships between these factors and the development and progression of early
Full Text Available Abstract Background Dental caries (decay during childhood is largely preventable however it remains a significant and costly public health concern, identified as the most prevalent chronic disease of childhood. Caries in children aged less than five years (early childhood caries is a rapid and progressive disease that can be painful and debilitating, and significantly increases the likelihood of poor child growth, development and social outcomes. Early childhood caries may also result in a substantial social burden on families and significant costs to the public health system. A disproportionate burden of disease is also experienced by disadvantaged populations. Methods/Design This study involves the establishment of a birth cohort in disadvantaged communities in Victoria, Australia. Children will be followed for at least 18 months and the data gathered will explore longitudinal relationships and generate new evidence on the natural history of early childhood caries, the prevalence of the disease and relative contributions of risk and protective biological, environmental and behavioural factors. Specifically, the study aims to: 1. Describe the natural history of early childhood caries (at ages 1, 6, 12 and 18 months, tracking pathways from early bacterial colonisation, through non-cavitated enamel white spot lesions to cavitated lesions extending into dentine. 2. Enumerate oral bacterial species in the saliva of infants and their primary care giver. 3. Identify the strength of concurrent associations between early childhood caries and putative risk and protective factors, including biological (eg microbiota, saliva, environmental (fluoride exposure and socio-behavioural factors (proximal factors such as: feeding practices and oral hygiene; and distal factors such as parental health behaviours, physical health, coping and broader socio-economic conditions. 4. Quantify the longitudinal relationships between these factors and the development and
Full Text Available Abstract Background Sulfur mustard (SM has been used as a chemical warfare agent since the early twentieth century. Despite the large number of studies that have investigated SM induced ocular injuries, few of those studies have also focused on the psychological health status of victims. This study has evaluated the most prominent influences on the psychological health status of patients with severe SM induced ocular injuries. Methods This descriptive study was conducted on 149 Iranian war veterans with severe SM induced eye injuries. The psychological health status of all patients was assessed using the Iranian standardized Symptom Check List 90-Revised (SCL90-R questionnaire. The results of patients' Global Severity Index (GSI were compared with the optimal cut-off point of 0.4 that has previously been calculated for GSI in Iranian community. The Mann-Whitney U test, T tests and effect sizes (using Cohen's d were employed as statistical methods. Data were analyzed using SPSS software. Results The mean age of patients was 44.86 (SD = 8.7 and mean duration of disease was 21.58 (SD = 1.20 years. Rate of exposure was once in 99 (66.4% cases. The mean GSI (1.46 of the study group was higher compared to standardized cut off point (0.4 of the Iranian community. The results of this study showed that the mean of total GSI score was higher in participants with lower educational levels (effect size = 0.507, unemployment (effect size = 0.464 and having more than 3 children (effect size = 0.62. Among the participants, 87 (58.4% cases had a positive psychological history for hospitalization or receiving outpatient cares previously and 62 (41.6% cases had a negative psychological history. In addition, the mean of GSI in participants with negative psychological history was lower than those with positive psychological history (Mean Change Difference = -0.621 with SD = 0.120. There was a significant difference between positive and negative psychological history
Fink, Wolfgang; Tarbell, Mark A.; Garcia, Kevin
Smart Ophthalmics© extends ophthalmic healthcare to people who operate/live in austere environments (e.g., military, third world, natural disaster), or are geographically dispersed (e.g., rural populations), where time, cost, and the possibility of travel/transportation make access to even adequate medical care difficult, if at all possible. Operators attach optical devices that act as ophthalmic examination extensions to smartphones and run custom apps to perform examinations of specific areas of the eye. The smartphone apps submit over wireless networks the collected examination data to a smart remote expert system, which provides in-depth medical analyses that are sent back in near real-time to the operators for subsequent triage.
Junk, Anna K; Chen, Philip P; Lin, Shan C; Nouri-Mahdavi, Kouros; Radhakrishnan, Sunita; Singh, Kuldev; Chen, Teresa C
(dilute bleach) offers effective disinfection against adenovirus and HSV, the viruses commonly associated with nosocomial outbreaks in eye care. Tonometer prisms should be examined regularly for signs of damage. Copyright © 2017 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.
Smith, Kasee L.; Rayfield, John
Project-based learning has been a component of agricultural education since its inception. In light of the current call for additional emphasis of the Supervised Agricultural Experience (SAE) component of agricultural education, there is a need to revisit the roots of project-based learning. This early historical research study was conducted to…
Graybill, Emily; Self-Brown, Shannon; Lai, Betty; Vinoski, Erin; McGill, Tia; Crimmins, Daniel
Early intervention is critical for improved prognosis and quality of life for young children with developmental delays and disabilities. Yet, disparities persist among underserved families with young children. These disparities include knowledge of child development, use of medical providers as referral sources, and later diagnosis. The current…
Knowles, Ann-Marie; Niven, Ailsa G.; Fawkner, Samantha G.; Henretty, Joan M.
This longitudinal study investigated the influence of maturation on physical self-perceptions and the relationship with physical activity in early adolescent girls (N = 150; mean age = 12.79 plus or minus 0.31). Physical characteristics were measured and participants completed the Physical Activity Questionnaire for Children, the Children and…
Rowe, R. Wanda; Packer, Samuel; Rosen, James; Bizais, Yves
A digital camera system has been constructed for obtaining reflectance images of the fundus of the eye with monochromatic light. Images at wavelengths in the visible and near infrared regions of the spectrum are recorded by a charge-coupled device array and transferred to a computer. A variety of image processing operations are performed to restore the pictures, correct for distortions in the image formation process, and extract new and diagnostically useful information. The steps involved in calibrating the system to permit quantitative measurement of fundus reflectance are discussed. Three clinically important applications of such a quantitative system are addressed: the characterization of changes in the optic nerve arising from glaucoma, the diagnosis of choroidal melanoma through spectral signatures, and the early detection and improved management of diabetic retinopathy by measurement of retinal tissue oxygen saturation.
Aharony, Israel; Michowiz, Shalom; Goldenberg-Cohen, Nitza
The promising role of cellular therapies in the preservation and restoration of visual function has prompted intensive efforts to characterize embryonic, adult, and induced pluripotent stem cells for regenerative purposes. Three main approaches to the use of stem cells have been described: sustained drug delivery, immunomodulation, and differentiation into various ocular structures. Studies of the differentiation capacity of all three types of stem cells into epithelial, neural, glial and vascular phenotypes have reached proof-of-concept in culture, but the correction of vision is still in the early developmental stages, and the requirements for effective in vivo implementation are still unclear. We present an overview of some of the preclinical findings on stem-cell rescue and regeneration of the cornea and retina in acute injury and degenerative disorders. PMID:28400789
Shujaat, Shehnilla; Jawed, Muhammad; Memon, Shahzad; Talpur, Khalid Iqbal
The objective of this study was to assess and determine the risk factors and treatment of dry eye disease in type 1 diabetes before any ocular surface or corneal complication occurs. This study was conducted at Sindh Institute of Ophthalmology And Visual Sciences, Hyderabad, Pakistan. Subjects and methods for observational study were undertaken at the Department of Ophthalmology Sindh Institute Of Ophthalmology And Visual Sciences, Hyderabad, Pakistan. Hundred confirmed cases of type 1 diabetes were included in the study by non probability convenience sampling. Tear film breakup time and schrimer test were carried out to determine dry eye disease. Data was collected by self-prepared questionnaire and entered and analyzed by using Statistical Program for Social Sciences (SPSS, version 20.0). The frequencies and percentage were recorded and any associations with predisposing factors were statistically analyzed by t test. Out of hundred patients, 71 (71%) were found to have dry eyes (P<0.001). The mean age of the subject in this study was 50.97 years (range 30-70 years). Old age was related to high risk of dry eye disease (P<0.001). There was no big difference in the incidence of dry eyes in males and females. Long duration was found to be related with increased occurrence of dry eyes (P<0.001). We found higher values for abnormal tear film break up time than schirmer test values leading to increased occurrence of evaporative dry eyes. There is marked increase in frequency/ risk of developing dry eye disease in type 1 diabetes patients. Therefore, it is recommended to have periodic ophthalmic examination for type 1 diabetic patients.
Shen, Carl; Shamsudeen, Isabel; Farrokhyar, Forough; Sabri, Kourosh
Evidence-based medicine is guided by our interpretation of randomized controlled trials (RCTs) that address important clinical questions. Evaluation of the robustness of statistically significant outcomes adds a crucial element to the global assessment of trial findings. The purpose of this systematic review was to determine the robustness of ophthalmology RCTs through application of the Fragility Index (FI), a novel metric of the robustness of statistically significant outcomes. Systematic review. A literature search (MEDLINE) was performed for all RCTs published in top ophthalmology journals and ophthalmology-related RCTs published in high-impact journals in the past 10 years. Two reviewers independently screened 1811 identified articles for inclusion if they (1) were a human ophthalmology-related trial, (2) had a 1:1 prospective study design, and (3) reported a statistically significant dichotomous outcome in the abstract. All relevant data, including outcome, P value, number of patients in each group, number of events in each group, number of patients lost to follow-up, and trial characteristics, were extracted. The FI of each RCT was calculated and multivariate regression applied to determine predictive factors. The 156 trials had a median sample size of 91.5 (range, 13-2593) patients/eyes, and a median of 28 (range, 4-2217) events. The median FI of the included trials was 2 (range, 0-48), meaning that if 2 non-events were switched to events in the treatment group, the result would lose its statistical significance. A quarter of all trials had an FI of 1 or less, and 75% of trials had an FI of 6 or less. The FI was less than the number of missing data points in 52.6% of trials. Predictive factors for FI by multivariate regression included smaller P value (P < 0.001), larger sample size (P = 0.001), larger number of events (P = 0.011), and journal impact factor (P = 0.029). In ophthalmology trials, statistically significant dichotomous results are often
Hashemi, Hassan; Asgari, Soheila; Shahhoseini, Saied; Mahbod, Mirgholamreza; Atyabi, Fatemeh; Bakhshandeh, Haleh; Beheshtnejad, Amir Houshang
The purpose of the study was to evaluate tissue reaction to polycaprolactone (PCL) nanofiber patches in the cornea, conjunctiva, and anterior chamber (AC) in rabbit eyes and to assess their biocompatibility for use as patch grafts. Two 100 μ PCL patches were implanted under the conjunctiva and in the corneal stroma of one albino New Zealand rabbit, and pathologic evaluation was done after 3 weeks. In the next step, two PCL patches were implanted; one in the corneal stroma and the other in the AC of two rabbits followed by pathologic evaluation after 3 months. On slit-lamp examination, there was minimum inflammation in all cases. Pathologic examination showed that the contact and probably merging between the host tissue and PCL fibers were achieved with minimal tissue reaction. As a biocompatible material, PCL nanofibers seem to be a promising modality for the repair of different tissue defects including melting, thinning, and perforation. They may also be a suitable material for manufacturing keratoprostheses.
Rhew, Isaac C; Fleming, Charles B; Vander Stoep, Ann; Nicodimos, Semret; Zheng, Cheng; McCauley, Elizabeth
Although they often co-occur, the longitudinal relationship between depression and substance use disorders during adolescence remains unclear. This study estimated the effects of cumulative depression during early adolescence (ages 13-15 years) on the likelihood of cannabis use disorder (CUD) and alcohol use disorder (AUD) at age 18. Prospective cohort study of youth assessed at least annually between 6th and 9th grades (~ age 12-15) and again at age 18. Marginal structural models based on a counterfactual framework that accounted for both potential fixed and time-varying confounders were used to estimate cumulative effects of depressive symptoms over early adolescence. The sample originated from four public middle schools in Seattle, Washington, USA. The sample consisted of 521 youth (48.4% female; 44.5% were non-Hispanic White). Structured in-person interviews with youth and their parents were conducted to assess diagnostic symptom counts of depression during early adolescence; diagnoses of CUD and AUD at age 18 was based the Voice-Diagnostic Interview Schedule for Children. Cumulative depression was defined as the sum of depression symptom counts from grades 7-9. The past-year prevalence of cannabis and alcohol use disorder at the age 18 study wave was 20.9 and 19.8%, respectively. A 1 standard deviation increase in cumulative depression during early adolescence was associated with a 50% higher likelihood of CUD [prevalence ratio (PR) = 1.50; 95% confidence interval (CI) = 1.07, 2.10]. Although similar in direction, there was no statistically significant association between depression and AUD (PR = 1.41; 95% CI = 0.94, 2.11). Further, there were no differences in associations according to gender. Youth with more chronic or severe forms of depression during early adolescence may be at elevated risk for developing cannabis use disorder compared with otherwise similar youth who experience fewer depressive symptoms during early adolescence. © 2017 Society
Venkataraman, Shruthi; Jordan, Gerald; Pope, Megan A; Iyer, Srividya N
To better understand cultural competence in early intervention for psychosis, we compared service users' and service providers' perceptions of the importance of providers being culturally competent and attentive to aspects of culture. At a Canadian early intervention programme, a validated scale was adapted to assess service user (N = 51) and provider (N = 30) perceptions of service providers' cultural competence and the importance accorded thereto. Analyses of variance revealed that the importance of service providers being culturally competent was rated highest by service providers, followed by visible minority service users, followed by white service users. Providers rated themselves as being more interested in knowing about service users' culture than service users perceived them to be. Service users accorded less import to service providers' cultural competence than providers themselves, owing possibly to varied socialization. A mismatch in users' and providers' views on providers' efforts to know their users' cultures may influence mental healthcare outcomes. © 2017 John Wiley & Sons Australia, Ltd.
Veneziani, Federica; Panza, Francesco; Solfrizzi, Vincenzo; Capozzo, Rosa; Barulli, Maria Rosaria; Leo, Antonio; Lozupone, Madia; Fontana, Andrea; Arcuti, Simona; Copetti, Massimiliano; Cardinali, Valentina; Grasso, Alessandra; Tursi, Marianna; Iurillo, Annalisa; Imbimbo, Bruno Pietro; Seripa, Davide; Logroscino, Giancarlo
We detected the general level of knowledge about the early diagnosis of Alzheimer's disease (AD) and subsequent care in general practitioners (GPs) from Southern Italy. We explored also the GP perception about their knowledge and training on diagnosis and management of AD. On a sample of 131 GPs, we administered two questionnaires: the GP-Knowledge, evaluating GPs' expertise about AD epidemiology, differential diagnosis, and available treatments, and the GP-QUestionnaire on Awareness of Dementia (GP-QUAD), assessing the GPs' attitudes, awareness, and practice regarding early diagnosis of dementia. Specific screening tests or protocols to diagnose and manage dementia were not used by 53% of our GPs. The training on the recognition of early AD signs and symptoms was considered inadequate by 55% of the participants. Females were more likely to consider their training insufficient (58%) compared to males (53%). Female GPs were less likely to prescribe antipsychotic drugs to control neuropsychiatric symptoms (NPS) and suggest specialist advice in late stage of cognitive impairment. Multiple Correspondence Analysis (MCA) performed only on GP-QUAD suggested two dimensions explaining 26.1% ("GP attitude") and 20.1% ("GP knowledge") of the inertia for a total of 46.2%, In our survey on GP clinical practice, several problems in properly recognizing early AD symptoms and subsequently screening patients to be referred to secondary/tertiary care centers for diagnosis confirmation have emerged. In the future, specific training programs and educational projects for GPs should be implemented also in Italy to improve detection rates and management of dementia in primary care.
Bohn, Gregory A; Schultz, Gregory S; Liden, Brock A; Desvigne, Michael N; Lullove, Eric J; Zilberman, Igor; Regan, Mary B; Ostler, Marta; Edwards, Karen; Arvanitis, Georgia M; Hartman, Jodi F
Normal wound healing is accomplished through a series of well-coordinated, progressive events with overlapping phases. Chronic wounds are described as not progressing to healing or not being responsive to management in a timely manner. A consensus panel of multidisciplinary wound care professionals was assembled to (1) educate wound care practitioners by identifying key principles of the basic science of chronic wound pathophysiology, highlighting the impact of metalloproteinases and biofilms, as well as the role of the extracellular matrix; and (2) equip practitioners with a systematic strategy for the prevention and healing of acute injuries and chronic wounds based upon scientific evidence and the panel members' expertise. An algorithm is presented that represents a shift in strategy to proactive and early aggressive wound management. With proactive management, adjunct therapies are applied preemptively to acute injuries to reduce wound duration and risk of chronicity. For existing chronic wounds, early aggressive wound management is employed to break the pathophysiology cycle and drive wounds toward healing. Reducing bioburden through debridement and bioburden management and using collagen dressings to balance protease activity prior to the use of advanced modalities may enhance their effectiveness. This early aggressive wound management strategy is recommended for patients at high risk for chronic wound development at a minimum. In their own practices, the panel members apply this systematic strategy for all patients presenting with acute injuries or chronic wounds.
Full Text Available Neurofibromatosis type 1, tuberous sclerosis complex, and Von Hippel-Lindau disease, historically classified as the phakomatoses, are hereditary multisystem disorders characterized by the presence of hamartoma, which carry the risk of malignant transformation. The alteration of tumor suppressor genes seems to be at the basis of their pathophysiogenetic mechanism. Lisch and choroidal nodules in neurofibromatosis type 1, retinal astrocytomas in tuberous sclerosis complex, and retinal capillary hemangioma in Von Hippel-Lindau disease are the principal ophthalmic hamartomatous manifestations. The advent of novel imaging techniques such as near infrared reflectance and optical coherence tomography has provided unprecedented insight on the choroidal and retinal features of these diseases. These methods have improved early diagnosis and the ongoing surveillance in these conditions. Among an array of treatment modalities, antivascular endothelial growth factor therapy has been used in the management of retinal hamartomas but results have been varied. This review is an update on the pathophysiogenetic mechanisms, ophthalmic manifestations, and novel treatment strategies in the phakomatoses with emphasis on the role of imaging techniques.
Shtein, Roni M; Harper, Daniel E; Pallazola, Vincent; Harte, Steven E; Hussain, Munira; Sugar, Alan; Williams, David A; Clauw, Daniel J
To improve understanding of dry eye disease and highlight a subgroup of patients who have a component of central sensitization and neuropathic pain contributing to their condition. Prospective, cross-sectional, IRB-approved study comparing isolated dry eye disease (n=48) to fibromyalgia (positive control; n=23) and healthy (negative control; n=26) individuals with ocular surface examination, corneal confocal microscopy, quantitative sensory testing, and self-reported ocular symptoms and systemic associations. A subset of patients also underwent skin biopsy and/or brain neuroimaging. Dry eye patients were split into concordant (ie, those with dry eyes on examination) and discordant (ie, those with dry eye symptoms but normal examination) subgroups for further analysis. We hypothesized that on the systemic measures included, concordant patients would resemble healthy controls, whereas discordant patients would show evidence of centralized mechanisms similar to fibromyalgia. Schirmer test and Ocular Surface Disease Index (OSDI) scores indicated significant decreases in tear production (Schirmer: healthy, 18.5±8.2 mm; dry, 11.2±5.4 mm; fibromyalgia, 14.4±7.5; P <.001) and increases in self-reported dry eye symptoms (OSDI: healthy, 1.9±3.0; dry, 20.3±17.7; fibromyalgia, 20.3±17.1; P <.001) in the dry eye and fibromyalgia patients, compared to controls. The discordant subgroup had decreased corneal nerve density and decreased visual quality-of-life scores, similar to patients with fibromyalgia. Concordant patients were more similar to healthy controls on these measures. Individuals with discordant dry eye may have a central pathophysiologic mechanism leading to their eye pain symptoms, which could be an important factor to consider in treatment of chronic idiopathic dry eye.
Full Text Available Invigorating blood and dissolving stasis method is a kind of unique therapy of Traditional Chinese Medicine(TCMtreatment, which efficacy has become increasingly prominent in the treatment of ophthalmology. With the further studies of blood stasis and invigorating blood and dissolving stasis therapy, it is widely used in clinical ophthalmology, and get good effects beyond thought, especially when western medicine has no curative effects. It improved the cure rate of fundus oculi disease from the eyelids, conjunctiva, lacrimal sac, vitreous body to the choroid and retina, optic nerve and macula lutea, from surface to fundus, or pathological changes related to inflammation, degeneration, necrosis, atrophy, hyperplasia of fibrous tissue hyperplasia. This paper is aim to explain the definition of invigorating blood and dissolving stasis and make a review of basic research and clinical application about it in several diseases.
Muller, Matthew P; Siddiqui, Naureen; Ivancic, Rose; Wong, David
Adenovirus-associated epidemic keratoconjunctivitis (A-EKC) is a cause of large and prolonged outbreaks in ophthalmology clinics and can result in substantial morbidity. A-EKC outbreaks are often the result of contaminated ophthalmologic equipment, surfaces, or hands. Contaminated multidose eye drops are also a likely culprit, but few prior studies provide clear epidemiologic evidence that adenovirus transmission resulted from contamination of eye drops. We describe an A-EKC outbreak at a large, hospital-affiliated eye clinic that affected 44 patients. The unique epidemiology of the outbreak provides strong evidence that contaminated multidose dilating eye drops resulted in adenovirus transmission. Removal of multidose eye medication from the clinic, combined with case finding, enhanced infection control and enhanced environmental cleaning, led to rapid control of the outbreak. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
Golnik, Karl C; Gauba, Vinod; Saleh, George M; Collin, Richard; Naik, Milind N; Devoto, Martin; Nerad, Jeffrey
To produce an internationally valid tool to assess skill in performing lateral tarsal strip surgery. A panel of 7 content experts adapted a previously published tool for assessing lateral tarsal strip surgery by using a modified Dreyfus scale of skill acquisition and providing behavioral descriptors for each level of skill in each category. The tools were then reviewed by 11 international content experts for their constructive comments. Experts' comments were incorporated, establishing face and content validity. The tool International Council of Ophthalmology-Ophthalmology Surgical Competency Assessment Rubric for Lateral Tarsal Strip Surgery has face and content validity. It can be used globally to assess lateral tarsal strip surgical skill. Reliability and predictive validity still need to be determined.
Xie, Li-xin; Gao, Hua
The femtosecond (FS) laser is a novel laser technology, and is approved clinical application by FDA in 2000. FS laser initially mainly used in corneal refractive surgery to replace the mechanical microkeratome. Since the accuracy and controllability of the FS laser is very high, it shows superiority in the field of corneal refractive surgery. And with the development of the relative hard and software, FS laser is began to used in other fields of ophthalmology, such as corneal transplants, cataract surgery, as well as assisted diagnosis et al., although still have some limitations, the preliminary clinical results have been shown a very good prospects in the ophthalmology fields. Therefore, we reviewed the alternative applications, challenges and limitations, research direction in the future of FS laser, so that provide a reference and revelations for the peers.
Radhakrishnan, Sunita; Chen, Philip P; Junk, Anna K; Nouri-Mahdavi, Kouros; Chen, Teresa C
To examine the efficacy and complications of laser peripheral iridotomy (LPI) in subjects with primary angle closure (PAC). Literature searches in the PubMed and Cochrane databases were last conducted in August 2017 and yielded 300 unique citations. Of these, 36 met the inclusion criteria and were rated according to the strength of evidence; 6 articles were rated level I, 11 articles were rated level II, and 19 articles were rated level III. Reported outcomes were change in angle width, effect on intraocular pressure (IOP) control, disease progression, and complications. Most of the studies (29/36, 81%) included only Asian subjects. Angle width (measured by gonioscopy, ultrasound biomicroscopy, and anterior segment OCT) increased after LPI in all stages of angle closure. Gonioscopically defined persistent angle closure after LPI was reported in 2% to 57% of eyes across the disease spectrum. Baseline factors associated with persistent angle closure included narrower angle and parameters representing nonpupillary block mechanisms of angle closure, such as a thick iris, an anteriorly positioned ciliary body, or a greater lens vault. After LPI, further treatment to control IOP was reported in 0%-8% of PAC suspect (PACS), 42% to 67% of PAC, 21% to 47% of acute PAC (APAC), and 83%-100% of PAC glaucoma (PACG) eyes. Progression to PACG ranged from 0% to 0.3% per year in PACS and 0% to 4% per year in PAC. Complications after LPI included IOP spike (8-17 mmHg increase from baseline in 6%-10%), dysphotopsia (2%-11%), anterior chamber bleeding (30%-41%), and cataract progression (23%-39%). Laser peripheral iridotomy increases angle width in all stages of primary angle closure and has a good safety profile. Most PACS eyes do not receive further intervention, whereas many PAC and APAC eyes, and most PACG eyes, receive further treatment. Progression to PACG is uncommon in PACS and PAC. There are limited data on the comparative efficacy of LPI versus other treatments for the
Full Text Available Purpose: The purpose of the study was to evaluate tissue reaction to polycaprolactone (PCL nanofiber patches in the cornea, conjunctiva, and anterior chamber (AC in rabbit eyes and to assess their biocompatibility for use as patch grafts. Methods: Two 100 μ PCL patches were implanted under the conjunctiva and in the corneal stroma of one albino New Zealand rabbit, and pathologic evaluation was done after 3 weeks. In the next step, two PCL patches were implanted; one in the corneal stroma and the other in the AC of two rabbits followed by pathologic evaluation after 3 months. Results: On slit-lamp examination, there was minimum inflammation in all cases. Pathologic examination showed that the contact and probably merging between the host tissue and PCL fibers were achieved with minimal tissue reaction. Conclusion: As a biocompatible material, PCL nanofibers seem to be a promising modality for the repair of different tissue defects including melting, thinning, and perforation. They may also be a suitable material for manufacturing keratoprostheses.