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1.
J Fr Ophtalmol ; 42(10): 1049-1055, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31727329

RESUMO

PURPOSE: To assess the ability of patients with exudative AMD to detect exudative recurrence. Another objective was to assess if self-monitoring, as currently taught, improves this ability. MATERIALS AND METHODS: An observational cross-sectional study was carried out in the ophthalmology center of BeauSoleil clinic in Montpellier between March 1 and April 1 2016. Inclusion criteria were presence of neovascular age related macular degeneration treated with the loading dose of three monthly intravitreal anti-VEGF injections, with at least one injection in the past 12 months and at least one exudative recurrence. All patients underwent a visual acuity measurement with ETDRS charts at 4 meters. A questionnaire assessed familiarity with the Amsler grid and its proper use, performance of and type of self-monitoring at home and the subjective feeling of an exudative recurrence at the visit with a 5-level Likert scale. RESULTS: A total of 94 eyes of 70 patients were included in this study with 69.0 % women and a median (interquartile range) age of 83 (77-96) years. Among them, 81 % performed regular self-monitoring, mostly with environmental Amsler tests (70 %). Only 63 % of the patients knew of the Amsler grid, among which 52 % used it correctly. Sensitivity (95 % confidence interval, 95 % CI) and specificity (95 % CI) of the subjective sensation of exudative recurrence were 0.32 (0.14-0.55) and 0.85 (0.74-0.92), respectively, for the entire population. Sensitivity (95 % CI) and specificity (95 % CI) were 0.33 (0.13-0.59) and 0.85 (0.74-0.93); 0.25 (0.0063-0.81) and 0.82 (0.48-0.98), respectively, in patients performing and not performing self-monitoring. CONCLUSION: Patients' prediction in wet AMD is insufficient in detecting exudative recurrences, even if regular self-monitoring with Amsler grid or environmental Amsler is performed.


Assuntos
Autoavaliação Diagnóstica , Exsudatos e Transudatos , Degeneração Macular/diagnóstico , Monitorização Fisiológica , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Exsudatos e Transudatos/fisiologia , Feminino , França , Humanos , Degeneração Macular/patologia , Masculino , Monitorização Fisiológica/métodos , Recidiva , Autocuidado/métodos , Autoeficácia , Sensibilidade e Especificidade , Degeneração Macular Exsudativa/diagnóstico , Degeneração Macular Exsudativa/patologia
2.
Clin Ter ; 165(5): 261-8, 2014.
Artigo em Italiano | MEDLINE | ID: mdl-25366947

RESUMO

We report a rare case of acute posterior multifocal placoid pigment epitheliopathy (APMPPE) in an elderly patient and a review of the recent scientific literature. A 65-year-old Caucasian man, forty-five days after return from tropical travel he developed right-sided facial palsy with right hemiplegia, dysarthria and a positive Babinski sign. He started prednisone 90 mg/day. Clinical, laboratory and imaging examinations were reported. Five months later there was a complete neurological and ophthalmological recovery. Although APMPPE was described primarily in young adults, we report the first case of APMPPE associated with neurological involvement in an older patient with a complete restitutio ad integrum.


Assuntos
Corioidite/diagnóstico , Corioidite/tratamento farmacológico , Epitélio Pigmentado Ocular/patologia , Doenças Retinianas/tratamento farmacológico , Doenças Retinianas/patologia , Epitélio Pigmentado da Retina/patologia , Doença Aguda , Idoso , Angiofluoresceinografia , Humanos , Masculino , Coroidite Multifocal , Prednisolona/uso terapêutico , Prednisona/uso terapêutico
4.
Issues Ment Health Nurs ; 19(6): 557-70, 1998.
Artigo em Inglês | MEDLINE | ID: mdl-9883131

RESUMO

The structural approach to family therapy offers a useful perspective to the nurse therapist working with families with various cultural backgrounds. Asian and Hispanic families are examined to illustrate using Minuchin's approach to family counseling. The rationale for the structural approach is explored, and specific therapeutic techniques for practice are described. Nurses who work with culturally diverse families might profit by using this approach.


Assuntos
Asiático/psicologia , Diversidade Cultural , Terapia Familiar/métodos , Hispânico ou Latino/psicologia , Modelos Psicológicos , Enfermagem Psiquiátrica/métodos , Papel (figurativo) , Atitude Frente a Saúde/etnologia , Humanos , Modelos de Enfermagem , Enfermagem Transcultural/métodos , Estados Unidos
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