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1.
Eye (Lond) ; 38(1): 76-81, 2024 01.
Artículo en Inglés | MEDLINE | ID: mdl-37355756

RESUMEN

OBJECTIVES: To investigate patient understanding of, and attitudes to, premium (toric, extended depth of focus/multifocal) intraocular lenses (premIOLs) in public health sector patients undergoing cataract surgery (CS) in the UK. METHODS: A 12 question survey with Likert scale questions was designed, to assess patient attitudes to post-operative spectacle dependence, refractive target and desirability of spectacle independence whilst considering possible complications of dysphotopsias and need for premIOL exchange/adjustment. RESULTS: 360 surveys were collected. CS had not been performed in 66.5%. Separate spectacles were worn for reading and distance in 28.8%, 19.2% had varifocals, 11.2% bifocals, 22.9% reading glasses only and 1.6% computer glasses only. Contact lenses were not worn in 95.7%. Only 41.6% were drivers. Most patients (85.8%) did not mind wearing glasses after CS, with 78.9% preferring reading glasses, compared with 29.7% preferring distance glasses. Most patients (75.3%) were not familiar with premIOLs, with 58.9% not willing to consider them in the context of a 2% risk of debilitating dysphotopsia and 54.2% rejecting a 5% risk of second surgery. CONCLUSIONS: There is a lack of awareness of premIOLs in public health sector (NHS) patients in the UK, suggesting limitations in the "fully informed" consent process for CS. Most NHS CS patients are currently willing to wear spectacles after CS, especially reading glasses. There is reluctance in such patients to consider premIOLs on a background of small risks of debilitating dysphotopsias and increased risks of a second operation.


Asunto(s)
Extracción de Catarata , Catarata , Lentes Intraoculares , Humanos , Salud Pública , Agudeza Visual
2.
Telemed J E Health ; 29(2): 270-277, 2023 02.
Artículo en Inglés | MEDLINE | ID: mdl-35704029

RESUMEN

Introduction: The utilization of telemedicine has been steadily rising and became more available during the coronavirus disease 2019 (COVID-19) pandemic to ensure the continuity of care and minimize the risk of exposure to the infection. The aim of this study was to evaluate patients' and caregivers' satisfaction to newly developed teleconsultation services at the internal medical outpatient clinics at a tertiary university hospital during the COVID-19 pandemic. Methods: A cross-sectional satisfaction evaluation was conducted between April 2020 and June 2020. Participants included patients or caregivers who were randomly selected to answer a multi-item questionnaire to measure satisfaction with the quality, effectiveness, and convenience of the service. Results: A total of 901 participants completed the satisfaction survey. Most of the patients were in the age group 45-64 years (43.7%). The main teleconsultation method was telephone call (99.2%) and 798 participants (88.6%) were satisfied with the quality of teleconsultation. There was no difference in satisfaction levels across the various specialty clinics or age groups. The service was viewed as convenient by 636 participants (70.5%) and 481 (56.6%) preferred to continue using telemedicine after the COVID-19 pandemic. Conclusion: The study revealed high level of satisfaction among patients and caregivers with the recently introduced teleconsultation services at internal medicine outpatient clinics during the COVID-19 pandemic, which is a relatively new concept in many countries. This opens the door to further utilize telemedicine as an integrated part to improve patient care beyond the pandemic.


Asunto(s)
COVID-19 , Consulta Remota , Telemedicina , Humanos , Persona de Mediana Edad , Instituciones de Atención Ambulatoria , COVID-19/epidemiología , Estudios Transversales , Pandemias , Satisfacción del Paciente , Consulta Remota/métodos , Telemedicina/métodos
3.
Eye (Lond) ; 36(12): 2304-2311, 2022 12.
Artículo en Inglés | MEDLINE | ID: mdl-34845355

RESUMEN

BACKGROUND/OBJECTIVES: To characterise the patterns of presentation and diagnostic frequencies in Hospital Emergency Eye Care Services (HEECS) across 13 hospitals in England. METHODS: Retrospective, cross-sectional, observational multi-centre (n = 13) study to assess HEECS attendances over a 28-day study period. Data derived included: number of consecutive attendances, patient demographics and diagnoses. Age and gender variations, the impact of day of the week on attendance patterns, diagnostic frequencies and estimates of the annual incidence and attendance rates were evaluated. RESULTS: A total of 17,667 patient (mean ± standard deviation age = 49.6 ± 21.8 years) attendances were identified with an estimated HEECS annual new attendance rate of 31.0 per 1,000 population. Significantly more females (53%) than males (47%) attended HEECS (p < 0.001). Female attendances were 13% higher in those ≥50 years of age. Weekends were associated with a significant reduction in attendances compared to weekdays (χ2 = 6.94, p < 0.001). Among weekdays, Mondays and Fridays were associated with significantly higher attendances compared with midweek (χ2 = 2.20, p = 0.032). Presenting pathologies involving the external eye, cornea and conjunctiva accounted for 28.6% of the caseload. CONCLUSION: This is the largest multicentre study assessing attendance patterns in HEECS in England. We have, for the first time, observed a "weekend effect" in relation to attendance to HEECS. Differences in health-seeking behaviour and lack of awareness of HEECS weekend services may be partly attributed to the differences observed. Our findings, along with the type of presentations, have the potential to guide commissioners with future planning of HEECS.


Asunto(s)
Servicio de Urgencia en Hospital , Hospitales , Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Anciano , Estudios Retrospectivos , Estudios Transversales , Inglaterra/epidemiología
4.
Clin Exp Optom ; 104(8): 859-863, 2021 11.
Artículo en Inglés | MEDLINE | ID: mdl-33689663

RESUMEN

Clinical relevance: Pars plana vitrectomy techniques have evolved in the recent years and the number of patients undergoing phacoemulsification for post-vitrectomy cataract has increased. Eye-care practitioners need to be aware of intraoperative complications and post-operative outcomes in previously vitrectomised eyes.Background: The aim of the present study is to compare the outcomes and related complications of phacoemulsification in previously vitrectomised versus non-vitrectomised eyes.Methods: This is a retrospective case-control study. Visual acuity, refractive outcomes, intra- and post-operative complications were analysed in consecutive phacoemulsification patients between January 2015 and August 2017. Patients with no post-operative data were excluded.Results: One hundred and forty-nine previously vitrectomised eyes and 608 non-vitrectomised eyes were included in the analysis. Previous pars plana vitrectomy was associated with worse logMAR visual acuity pre-operatively (0.75 ± 0.54 vs. 0.40 ± 0.33, p < 0.0001) and post-operatively (0.15 ± 0.29 vs. 0.09 ± 0.22, p = 0.014). There were no statistically significant differences between the two groups regarding refractive outcomes (p = 0.393) or posterior capsule rupture rate (p = 0.223). Previous pars plana vitrectomy was associated with a higher risk of post-operative macular oedema (p = 0.046) and posterior capsule opacification (p < 0.0001).Conclusions: Previous pars plana vitrectomy was not associated with a higher risk of intraoperative complications. However, a higher incidence of cystoid macular oedema and posterior capsule opacification were identified in the present study. Further research can provide insight into the mechanisms involved and any appropriate prevention strategies for these conditions.


Asunto(s)
Extracción de Catarata , Catarata , Facoemulsificación , Estudios de Casos y Controles , Catarata/epidemiología , Humanos , Complicaciones Intraoperatorias/epidemiología , Complicaciones Intraoperatorias/etiología , Facoemulsificación/efectos adversos , Complicaciones Posoperatorias/epidemiología , Complicaciones Posoperatorias/etiología , Estudios Retrospectivos , Resultado del Tratamiento , Vitrectomía
5.
Eye (Lond) ; 35(5): 1340-1346, 2021 May.
Artículo en Inglés | MEDLINE | ID: mdl-32601501

RESUMEN

BACKGROUND: Direct referrals from optometrists account for up to 10% eye casualty attendances. Despite this, there remains a paucity of literature on optometrist referrals to eye casualty. A better understanding of these referrals could be helpful in the development of shared care emergency pathways. Diagnostic agreement between optometrists and ophthalmologists for emergency referrals can be used to identify areas for development of shared care working strategies in emergency ophthalmology. METHODS: A retrospective evaluation of 1059 consecutive optometric emergency referrals to Moorfields Eye Hospital was conducted. Referrals were only included when a letter or documentation for the reason for referral was provided. Diagnostic information from the referring optometrist and casualty doctor was summarised for each patient by an investigator (VMT) and recorded on a single spreadsheet. These clinical summaries were compared by a second independent investigator (IJ) and marked as agreeing, disagreeing or uncertain. Each clinical summary was then mapped to a diagnostic category using key word searches which were manually re-checked against the original summaries. Information on the timing of the referral and the outcome at the emergency department visit was also collated. Inter-observer agreement for diagnostic categories was measured using kappa coefficients. RESULTS: Diagnostic agreement ranged between kappa 0.59 and 0.87. It was best for diagnoses within the red eye category (kappa 0.87). Compliance with College of Optometrists referral guidance ranged between 11 and 100%. More than half of referrals for elevated intra-ocular pressure were discharged at the eye casualty visit. Overall, 54% of patients were managed with advice alone, 39% required treatment following referral and 7% required onward referral from eye casualty. CONCLUSION: The majority of patients referred by optometrists were managed with advice alone. A collaborative approach at the point referral could be helpful to improve referral efficiency.


Asunto(s)
Oftalmología , Optometristas , Optometría , Servicio de Urgencia en Hospital , Inglaterra , Humanos , Derivación y Consulta , Estudios Retrospectivos
6.
Int J Appl Basic Med Res ; 10(3): 183-188, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33088741

RESUMEN

BACKGROUND: Demographic and epidemiological transitions have increased the life expectancy of middle aged women, resulting in higher burden of morbidities related to menopausal symptoms and also effect the quality of life (QOL). OBJECTIVES: To study the prevalence of menopausal symptoms and its effect on QOL among rural middle aged women (40-60 years) of Haryana, India. MATERIALS AND METHODS: A community based cross-sectional study was conducted in 400 middle aged women (40-60 years) from April 2018 to March 2019 by random sampling technique. The menopause rating scale was used to assess the prevalence of menopausal symptoms and the QOL and data were collected for sociodemographic factors, relevant menstrual history and other variables. RESULTS: Prevalence of menopausal symptoms was found to be 87.7%. Majority of the study subjects had anxiety (80%), followed by physical and mental exhaustion (71.5%), sleep problem (61.2%), irritability (60.7%), Joint and muscular discomfort (56%) and heart problems (54%). The most classical symptom of menopause i.e., hot flushes were reported in 36.7%. The mean age of menopause was 47.53 standard deviation 4.5 years. Statistical significant difference was seen for the mean score of few symptoms i.e., hot flushes, sweating (P < 0.003) and joint and muscular discomfort (P < 0.014) between post and peri-menopausal groups. The QOL was impaired in 70.2% of study subjects. The psychological symptoms attributed 70.8% to the poor QOL. CONCLUSION: To improve the QOL and to decrease the menopausal symptoms in these women, a holistic approach in the form of lifestyle and behavioral modification are required.

7.
J Family Med Prim Care ; 9(4): 2040-2044, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-32670962

RESUMEN

CONTEXT: Despite so many efforts to control dengue, the disease has a huge impact on the health, well-being, and economy of the population. The key success to control dengue depends not only on services provided by health authorities but also on the awareness of the community about preventing practices and their health-seeking behavior. Hence, the present study was conducted to assess the awareness regarding dengue and its determinants among urban adult population of Rohtak. AIMS: To assess the awareness regarding dengue and its determinants among urban adult population of Rohtak. SETTINGS AND DESIGN: A cross-sectional study. METHODS AND MATERIALS: Data were collected using a pretested, semi-structured interview schedule from 210 participants which included information on the demographic profile of the subject, awareness about the symptoms, transmission, vector behavior in terms of biting time and breeding places, preventive measures and treatment of dengue fever, and responsibility of vector control. Cumulative awareness was calculated on the basis of correct answers provided. STATISTICAL ANALYSIS USED: Categorical data were presented as a percentage. Pearson's Chi-square test was used to evaluate differences between groups for categorical variables. RESULTS: The level of awareness was better among males (statistically significant). The difference in the level of awareness with respect to education, occupation, and the socioeconomic class was found highly statistically significant. CONCLUSIONS: Awareness regarding dengue and its preventive measures were specifically low in women; mostly housewives, in participants of the lower socioeconomic group, and those who were illiterate.

9.
Eye (Lond) ; 34(7): 1224-1228, 2020 07.
Artículo en Inglés | MEDLINE | ID: mdl-32439878

RESUMEN

EEC staff were provided with rapidly changing personal PPE guidance by Public Health England (PHE) with specific subspecialty advice from the British Emergency Eye Care Society (BEECS) and the Royal College of Ophthalmologists (RCOphth) UK during the COVID19 pandemic. BEECS undertook a baseline survey of its members after the initial response from the RCOphth 16/3/20 mirroring Public Health England (PHE) advice and a follow- up survey after the guidance was updated on 9/4/20. A combined total of 84 responses were received. Improvements after RCOphth changes between the two surveys from hospital respondents showed increases in temperature screening (13%), scrub use (34%), use of aprons (31%), masks (4%), eye protection (35%), gloves (25%) and slit lamp guard (1%). Our findings demonstrate a positive and significant adaptation of PPE in response to change in guidance published by PHE, RCOphth and BEECS between 16/3/20 and 11/4/20. The COVID19 pandemic has rapidly taken over the normal activity of Ophthalmic departments creating unprecedented challenges. Following initial confusion and vulnerability expressed by EEC professionals to PPE guidance, most Trusts appear to have adapted and are doing similar things. The response has been swift and effective as a result of good team work and early advice from BEECS and the RCOphth. On the whole, management teams are listening.


Asunto(s)
COVID-19 , Equipo de Protección Personal , Inglaterra/epidemiología , Humanos , Oftalmología , Pandemias , SARS-CoV-2 , Reino Unido/epidemiología
10.
BMJ Open Ophthalmol ; 5(1): e000554, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-34192150

RESUMEN

OBJECTIVE: To ascertain patient acceptance of immediate sequential bilateral cataract surgery (ISBCS) in the National Health Service (NHS). METHODS: A survey was devised using a 5-point Likert scale for questions related to ISBCS, which patients undertook during their cataract outpatient appointment pre-COVID-19 lockdown and by telephone during the lockdown. RESULTS: Questionnaires were completed for 267 patients. Most respondents were aged over 71 (51%) and were female individuals (60%). Forty-five per cent agreed/strongly agreed with opting for ISBCS. A positive correlation was identified between opting for ISBCS and convenience to the patient (r=0.76, p<0.01) and family/carer/partner (r=0.71, p<0.01) and wanting to limit numbers of hospital visits (r=0.57, p<0.01). Fifty per cent agreed/strongly agreed that they were worried about the risk of simultaneous bilateral ocular complications, with this correlating with being less likely to opt for ISBCS (r=-0.49, p<0.01) and being scared of ISBCS (r=0.67, p<0.01). During COVID-19 lockdown, patients were less likely to want to minimise the time taken off work (p<0.05) and less intolerant of a prolonged hospital visit (p<0.05). Only 23% of respondents agreed/strongly agreed that they had familiarity with ISBCS. CONCLUSIONS: ISBCS was acceptable to 45% of our sampled population, suggesting limited routine implementation in the NHS is possible. Convenience and reduction in hospital visits appeared to contribute to this acceptance. Half of the patients expressed concern regarding bilateral complications and such concerns need addressing. Some attitudes did appear to change during the COVID-19 lockdown period. The familiarity of the concept of ISBCS is low suggesting the need for patient education.

11.
Community Eye Health ; 31(103): 57, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-30487678
12.
Br J Ophthalmol ; 102(12): 1621-1628, 2018 12.
Artículo en Inglés | MEDLINE | ID: mdl-30232172

RESUMEN

BACKGROUND/AIMS: Acanthamoeba keratitis (AK) is a chronic debilitating corneal infection principally affecting contact lens (CL) users. Studies were designed to test claims that the UK incidence may have increased in 2012-2014 and to evaluate potential causes. METHODS: Annualised incidence data were collected from January 1984 to December 2016. Case-control study subjects were recruited between 14 April 2011 and 05 June 2017. Reusable CL users with AK were recruited retrospectively and prospectively. Controls were reusable CL users, recruited prospectively, with any disorder other than AK. Multivariable analysis of questionnaire data measured independent risk factors for AK. RESULTS: The current outbreak of AK started in 2010-2011 with an incidence threefold higher than in 2004-2009. Risk factors for AK were: Oxipol disinfection, CLs made of group IV CL materials, poor CL hygiene, deficient hand hygiene, use of CLs while swimming or bathing, being white British, and for those in social classes 4-9. CONCLUSION: AK is a largely preventable disease. The current outbreak is unlikely to be due to any one of the identified risk factors in isolation. Improving CL and hand hygiene, avoiding CLs contamination with water and use of effective CL disinfection solutions, or daily disposable CLs, will reduce the incidence of AK. In the longer-term, water avoidance publicity for CL users can be expected to reduce the incidence further. Ongoing surveillance of AK numbers will identify changes in incidence earlier. Evaluation of Acanthamoeba contamination in end-user drinking water would contribute to our understanding of regional variations in the risk of exposure.


Asunto(s)
Queratitis por Acanthamoeba/epidemiología , Lentes de Contacto/parasitología , Brotes de Enfermedades/estadística & datos numéricos , Higiene/normas , Queratitis por Acanthamoeba/parasitología , Adolescente , Adulto , Anciano , Estudios de Casos y Controles , Soluciones para Lentes de Contacto , Etnicidad , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Factores de Riesgo , Clase Social , Reino Unido/epidemiología , Adulto Joven
13.
BMJ Case Rep ; 20172017 Sep 18.
Artículo en Inglés | MEDLINE | ID: mdl-28924000

RESUMEN

Three unrelated patients attended the accident and emergency department with pain and blurred vision after ocular injury with a Nerf gun. Two were adults and one was a child, all of which presented within a 3 months' period. All three cases were found to have ≥1 mm of traumatic hyphema (pooling of blood in anterior chamber of the eye), indicating significant ocular trauma. The two adult patients had formed hyphema and uveitis. The 11-year-old child had formed hyphema, corneal oedema, anterior uveitis, localised angle recession and commotio retinae, which further highlight the severity of the ocular trauma. Significant Nerf gun ocular injuries are not reported in the literature, as far as we know. This case series serves to raise awareness of the seriousness of Nerf gun ocular injuries. It encourages further exploration of reasons for such injuries, as well as a review of protective measures against ocular trauma.


Asunto(s)
Lesiones Oculares/diagnóstico , Hipema/diagnóstico , Heridas por Arma de Fuego/diagnóstico , Adulto , Niño , Diagnóstico Diferencial , Lesiones Oculares/complicaciones , Lesiones Oculares/diagnóstico por imagen , Femenino , Humanos , Hipema/complicaciones , Hipema/diagnóstico por imagen , Masculino , Dolor/etiología , Juego e Implementos de Juego , Baja Visión/etiología , Heridas por Arma de Fuego/complicaciones , Heridas por Arma de Fuego/diagnóstico por imagen
14.
J Mol Model ; 23(8): 239, 2017 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-28741112

RESUMEN

BACE-1 and GSK-3ß are potential therapeutic drug targets for Alzheimer's disease. Recently, both the targets received attention for designing dual inhibitors for Alzheimer's disease. Until now, only two-scaffold triazinone and curcumin have been reported as BACE-1 and GSK-3ß dual inhibitors. Docking, molecular dynamics, clustering, binding energy, and network analysis of triazinone derivatives with BACE-1 and GSK-3ß was performed to get molecular insight into the first reported dual inhibitor. Further, we designed and evaluated a naphthofuran series for its ability to inhibit BACE-1 and GSK-3ß with the computational approaches. Docking study of naphthofuran series showed a good binding affinity towards both the targets. Molecular dynamics, binding energy, and network analysis were performed to compare their binding with the targets and amino acids responsible for binding. Naphthofuran series derivatives showed good interaction within the active site residues of both of the targets. Hydrogen bond occupancy and binding energy suggested strong binding with the targets. Dual-inhibitor binding was mostly governed by the hydrophobic interactions for both of the targets. Per residue energy decomposition and network analysis identified the key residues involved in the binding and inhibiting BACE-1 and GSK-3ß. The results indicated that naphthofuran series derivative 11 may be a promising first-in-class dual inhibitor against BACE-1 and GSK-3ß. This naphthofuran series may be further explored to design better dual inhibitors. Graphical abstract Naphthofuran derivative as a dual inhibitor for BACE-1 and GSK-3ß.


Asunto(s)
Enfermedad de Alzheimer/tratamiento farmacológico , Secretasas de la Proteína Precursora del Amiloide/antagonistas & inhibidores , Ácido Aspártico Endopeptidasas/antagonistas & inhibidores , Furanos/farmacología , Glucógeno Sintasa Quinasa 3 beta/antagonistas & inhibidores , Simulación de Dinámica Molecular , Naftalenos/farmacología , Enfermedad de Alzheimer/enzimología , Análisis por Conglomerados , Biología Computacional , Furanos/uso terapéutico , Humanos , Simulación del Acoplamiento Molecular , Naftalenos/uso terapéutico
15.
Br J Ophthalmol ; 99(9): 1186-9, 2015 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-25824258

RESUMEN

BACKGROUND: To estimate the diagnostic accuracy (sensitivity and specificity) of the AdenoPlus point-of-care adenoviral test compared to PCR in an ophthalmic accident and emergency service. These findings were compared with those of a previous study. METHODS: This was a prospective diagnostic accuracy study on 121 patients presenting to an emergency eye unit with a clinical picture of acute adenoviral conjunctivitis. AdenoPlus testing was carried out on one eye of each patient and a PCR analysis was also performed on a swab taken from the same eye. AdenoPlus and PCR results were interpreted by masked personnel. Sensitivity and specificity for the AdenoPlus test were calculated using PCR results as the reference standard. RESULTS: 121 patients were enrolled and 109 met the inclusion criteria. 43 patients (39.4%) tested positive for adenovirus by PCR analysis. The sensitivity of the AdenoPlus swab in detecting adenovirus was 39.5% (17/43, 95% CI 26% to 54%) and specificity was 95.5% (63/66, 95% CI 87% to 98%) compared to PCR. CONCLUSIONS: The AdenoPlus test has a high specificity for diagnosing adenoviral conjunctivitis, but in this clinical setting, we could not reproduce the high sensitivity that has been previously published.


Asunto(s)
Infecciones por Adenovirus Humanos/diagnóstico , Conjuntivitis Viral/diagnóstico , Técnicas de Diagnóstico Oftalmológico , Servicio de Urgencia en Hospital/estadística & datos numéricos , Sistemas de Atención de Punto/normas , Enfermedad Aguda , Adenovirus Humanos/genética , Adenovirus Humanos/aislamiento & purificación , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Conjuntivitis Viral/virología , ADN Viral/análisis , Femenino , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Reacción en Cadena de la Polimerasa/métodos , Estudios Prospectivos , Sensibilidad y Especificidad , Adulto Joven
16.
J Surg Educ ; 72(4): 585-91, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-25697511

RESUMEN

OBJECTIVE: Although theory-based schemes for course design are widely used in educational settings, making use of cognitive theory in the design of surgical skills courses in ophthalmology is rare. The primary aim of this study is to describe the application of instructional design, an established theory-based approach in course design, to the development of a surgical skills course for ophthalmology residents. The secondary aim of this study is to assess the educational effect of this theory-based course. DESIGN: A 1-day skills course was designed according to Gagné׳s events of instruction model, which was employed as a template for the instructional sequence of learning steps. Skills acquisition following the implementation of the model was measured with precourse and postcourse assessments. SETTING: Moorfields Eye Hospital organized the 1-day annual intermediate surgical skills course, which was hosted at the Royal College of Ophthalmologists' microsurgical skills laboratory. PARTICIPANTS: A total of 20 ophthalmology residents of Moorfields Eye Hospital participated in the study. RESULTS: A 1-day surgical skills course was formulated according to the instructional design principles outlined. The 4 objectives of the course (corneal suturing, corneal gluing, intravitreal injections, and eyelid suturing) were addressed in a parallel fashion as to allow for multiple objectives to be processed simultaneously, in the context of the instructional design sequence. Assessments demonstrated significant improvement in skills acquisition for the 4 course objectives. CONCLUSIONS: Instructional design is a valuable tool for planning effective surgical training courses as it is portable, allowing its application to a wide variety of outcomes and settings, and its terminology is simple and understandable to those working in clinical education.


Asunto(s)
Competencia Clínica , Educación de Postgrado en Medicina/métodos , Microcirugia/educación , Modelos Educacionales , Oftalmología/educación , Curriculum , Evaluación Educacional , Humanos , Internado y Residencia , Destreza Motora
18.
Cont Lens Anterior Eye ; 35(6): 285-7, 2012 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-22898257

RESUMEN

PURPOSE: The incidence of sports associated ocular injuries presenting to emergency departments is rising. Despite this, eye protection is not widely used in the general population. This survey was conducted to determine the spectrum of ocular sports injuries that presented to the emergency department of an ophthalmic hospital, which serves a large sector of inner city London. The role of eye protection in preventing ocular sports injuries was also investigated. METHODS: All patients who attended the emergency department with sports associated ocular injuries between May and July 2008 were identified. Medical records of these patients were examined. RESULTS: There were a total of 16999 ophthalmic emergency attendances. 48 (0.28%) patients presented with sports related ocular injuries. The outcomes of the consultations were: 13 (27.1%) patients discharged from the emergency department, 17 (35.4%) had reviews arranged in the emergency department, 18 (37.5%) referred to subspecialties. The mean presenting LogMAR visual acuities of patients that were discharged, reviewed in the emergency department, and referred to subspecialties were 0.01 (±0.33), 0.48 (±0.75), and 0.31 (±0.61) respectively. Visual acuities were better by 0.39 (95% CI 0.01-0.77, p=0.042) in patients who were discharged compared to patients who were reviewed in the emergency department or referred to subspecialties. Evaluation of records revealed that no patients wore eye protection and none were given advice regarding prevention of future injuries. CONCLUSION: Results from this survey show that ocular sports injuries account for a proportion of ophthalmic emergency attendances with a potential impact on service provision. It is essential that ophthalmologists, optometrists and other healthcare professionals are aware of the potential ocular morbidity from sports trauma and the importance of providing advice on the prevention of such injuries.


Asunto(s)
Traumatismos en Atletas/epidemiología , Traumatismos en Atletas/prevención & control , Servicio de Urgencia en Hospital/estadística & datos numéricos , Lesiones Oculares/epidemiología , Lesiones Oculares/prevención & control , Dispositivos de Protección de los Ojos/estadística & datos numéricos , Adulto , Recolección de Datos , Femenino , Humanos , Incidencia , Masculino , Factores de Riesgo , Reino Unido/epidemiología
19.
Nanomedicine ; 8(4): 452-9, 2012 May.
Artículo en Inglés | MEDLINE | ID: mdl-21839056

RESUMEN

Monodispersed, superparamagnetic nickel cobaltite (NCO) nanoparticles were functionalized using mercaptopropionic acid (MPA). MPA conjugates with NCO forming a metal-carboxylate linkage, with the MPA-MPA interaction occurring via formation of disulfide bonds, leaving another carboxyl end free for additional conjugation. The cytotoxicity studies on NCO-MPA show cell viability of ∼100% up to a dosage of 40 µg/mL on SiHa, MCF7, and B16F10 cell lines, and on mouse primary fibroblasts. Time-dependent cell viability studies done for a duration of 72 hours showed the cell lines' viability up to 80% for dosages as high as 80 µg/mL. Negligible leaching (<5 ppm) of ionic Co or Ni was noted into the delivery medium. Upon subjecting the NCO-MPA dispersion (0.1 mg/mL) to radiofrequency absorption, the nanoparticles were heated to 75°C within 2 minutes, suggesting its promise as a magnetic hyperthermia agent. Furthermore, the amino acid lysine and the drug cephalexin were successfully adducted to the NCO system, suggesting its potential for drug delivery. FROM THE CLINICAL EDITOR: NCO-MPA nanopartciles were found to be promising magnetic hyperthermia agents, suggesting potential future clinical applications.


Asunto(s)
Antibacterianos/farmacología , Materiales Biocompatibles/farmacología , Cefalexina/farmacología , Sistemas de Liberación de Medicamentos/métodos , Fiebre/tratamiento farmacológico , Ensayo de Materiales , Nanopartículas , Animales , Materiales Biocompatibles/síntesis química , Línea Celular Tumoral , Supervivencia Celular/efectos de los fármacos , Evaluación Preclínica de Medicamentos , Humanos , Lisina/farmacología , Ratones
20.
Langmuir ; 27(21): 13189-97, 2011 Nov 01.
Artículo en Inglés | MEDLINE | ID: mdl-21894994

RESUMEN

In the present study, a facile one-pot synthetic route, utilizing a strong polar organic solvent, N-methyl 2-pyrrolidone (NMP), is demonstrated to obtain highly monodispersed ferrite nanocrystals. The equimolar mixture of oleic acid, C(17)H(33)COOH (R-COOH), and oleylamine, C(18)H(35)NH(2) (R'-NH(2)), was used to coat the magnetic nanocrystals. Structural and magnetic properties of the ferrite nanocrystals were studied by a multitechnique approach including X-ray diffraction (XRD), high resolution transmission electron microscopy (HRTEM), Fourier transform infrared (FTIR) spectroscopy, thermogravimetric analysis (TGA), X-ray photoelectron spectroscopy (XPS), vibrating sample magnetometry (VSM), and Mössbauer spectroscopy. FTIR spectral analysis indicates oleylamine helps in deprotonation of oleic acid, resulting in the formation of an acid-base complex, R-COO¯:NH(3)(+)-R', which acts as binary capping agent. Structural and coordination differences of iron were studied by XPS and Mössbauer spectral analysis. XPS analysis was carried out to examine the oxidation state of iron ions in iron oxide nanocrystals. The presence of a magnetically dead layer (∼0.38 and ∼0.67 nm) and a nonmagnetic organic coating (∼2.3 and ∼1.7 nm) may substantially reduce the saturation magnetization values for CoFe(2)O(4) and Fe(3)O(4) nanocrystals, respectively. The energy barrier distribution function of magnetic anisotropy was derived from the temperature dependent decay of magnetization. A very narrow energy barrier distribution elucidates that the ferrite nanocrystals obtained in this study are highly monodispersed.

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