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1.
Cornea ; 2022 Feb 19.
Artigo em Inglês | MEDLINE | ID: mdl-35184127

RESUMO

PURPOSE: Glaucoma is a cause of comorbidity in patients receiving the Boston keratoprosthesis (KPro). The aim of this study was to report the outcomes of the Boston KPro with or without glaucoma surgery. METHODS: This was a retrospective single-center cohort study. Patients who underwent Boston KPro from March 2009 to February 2019 were included. One eye per patient (the first surgery) was included in this study. Patients were classified into 2 groups: KPro only (group 1) and KPro with any form of glaucoma procedure (group 2). Main outcome measures were Best-corrected visual acuity (BCVA), functional success (BCVA 20/200 or better), anatomical success (retention of KPro at the last follow-up), and complications. RESULTS: Seventy-one eyes were included: 27 eyes (38%) in group 1 and 44 (62%) in group 2. There was no statistically significant difference in BCVA between groups 1 and 2 at each time point. Of the eyes in group 1, 11% lost light perception vision and 4.5% in group 2 (P = 0.293). There was no difference in anatomical success with 70% in group 1 and 77% in group 2 (P = 0.703) at the last follow-up, with a median failure time of 18 months. The functional success was 48% for group 1 and 50% for group 2 (P = 0.541). CONCLUSIONS: Eyes undergoing KPro with glaucoma surgery before or at the same time carry a similar functional and anatomical success to eyes without glaucoma surgery.

2.
PLoS One ; 17(1): e0261967, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35025910

RESUMO

PURPOSE: Mental health is a significant problem following exposure to a traumatic event. This study aimed to examine quarantine-related experiences, traumatic stress, and coping strategies among adults quarantined in Saudi Arabia due to coronavirus disease 2019 (COVID-19) exposure or travel history. METHODS: Individuals aged ≥ 18 years who were quarantined in Saudi Arabia due to COVID-19 exposure or travel history were included. We used a sequential mixed methods design, using an online survey followed by in-depth individual telephonic interviews. The Impact of Event Scale-Revised (IES-R) was used to measure post-traumatic stress disorder (PTSD) symptoms after the quarantine. To identify factors associated with significant symptoms (IES-R score ≥ 33), prevalence ratios (PR) with 95% confidence intervals were computed using Poisson regression with robust error variance. In the next phase, a subset of the participants (n = 26) were interviewed to elicit their quarantine-related experiences and coping responses. Major themes and subthemes were identified. RESULTS: Of the 111 adults who completed the survey, 32 (28.8% [95% CI, 21.1-38.0%]) had significant PTSD symptoms (IES-R score ≥ 33) and 27 (24.3% [95% CI, 17.2-33.3%]) had severe symptoms (IES-R score > 37). Marital status was the only variable that was significantly associated with significant PTSD symptoms (P = 0.028). Significant symptoms were twice as prevalent in married adults than among other marital groups (PR 2.00, 95% CI, 1.08-3.72). Participants reported negative emotions such as overwhelming fear, helplessness, anxiety, and disgust. Participants utilized both problem-centered coping (e.g., use of social support) and emotion-centered coping (e.g., use of positive diversionary activities) during the quarantine period. CONCLUSION: PTSD symptoms were present in one out of every four quarantined persons. The quarantine experience is viewed negatively. These findings highlight the need for increased awareness about stress-related disorders among quarantined individuals. Efforts are needed to detect and manage these symptoms early while making the quarantine experience more satisfying for the involved individuals and groups.


Assuntos
COVID-19/psicologia , Quarentena/psicologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Estresse Psicológico/psicologia , Adulto , Ansiedade/psicologia , Transtornos de Ansiedade/psicologia , Medo/psicologia , Feminino , Humanos , Masculino , Saúde Mental , Pessoa de Meia-Idade , Pandemias/prevenção & controle , Satisfação Pessoal , Prevalência , SARS-CoV-2/patogenicidade , Arábia Saudita , Apoio Social/psicologia , Inquéritos e Questionários
3.
BMC Ophthalmol ; 21(1): 99, 2021 Feb 23.
Artigo em Inglês | MEDLINE | ID: mdl-33622287

RESUMO

BACKGROUND: The use of a tissue patch graft is common practice with a glaucoma drainage device (GDD). Patch grafts can be visible in the palpebral fissure and may be cosmetically displeasing for some patients. The aim of this study was to report the cosmetic satisfaction of pericardial, scleral, and corneal patch grafts related to superior GDD surgery. METHODS: Baseline clinical data were collected for consecutive patients with glaucoma operated between 2014 and 2019 at two tertiary eye care institutions (for superiorly-placed) Ahmad glaucoma valve implant using sclera, cornea and pericardium patch graft. A patient questionnaire that contained 4 concise questions, with a Likert-scale grading relating to cosmetic satisfaction was administered by a telephone-based interview. Responses and scores for each question were compared across patients who received the three different types of graft. A binominal logistic regression analysis was used to assess the effects of age, gender, type of graft, number of previous ocular surgeries, and final visual acuity to explain differences. RESULTS: We included 92 patients who met our inclusion criteria (24 patients received a corneal patch graft, 30 who received sclera and 38 who received pericardium). The mean (±SD) age was 50 (±17.5) years, and the average follow up was 20.7 (± 18.6) months. Regardless of the type of patch graft, most (67-84%) of patients were satisfied with the appearance of their eyes. Patients who received cornea or sclera were more likely to report that their eye looked 'abnormal' by others. Younger age was significantly associated with the response to this question. CONCLUSION: Patients are generally satisfied with the appearance of their eye following GDD surgery with each of the patch grafts for superiorly-placed GDDs. Younger patients with cornea or sclera were more likely to report that their eyes looked abnormal.


Assuntos
Implantes para Drenagem de Glaucoma , Satisfação Pessoal , Adulto , Idoso , Humanos , Pressão Intraocular , Pessoa de Meia-Idade , Satisfação do Paciente , Implantação de Prótese , Estudos Retrospectivos
4.
Cureus ; 13(1): e12681, 2021 Jan 13.
Artigo em Inglês | MEDLINE | ID: mdl-33598373

RESUMO

Purpose To assess ophthalmologists' preparedness in such a critical period in the history of pandemics, a logical socio-psychological framework assessment using the health belief model (HBM) is essential to evaluate their risk perception, their willingness to actively participate in engaging in protective health behavior and acknowledge its benefits, and their capability to perform adequate successful methods for limiting the spread of coronavirus disease 2019 (COVID-19) and overcome the barriers they might encounter while implementing such precautions. Methods A cross-sectional study conducted at King Khaled Eye Specialist Hospital using a questionnaire-based (HBM) was distributed to 135 ophthalmologists in the institute to evaluate their risk perception of COVID-19 and determine which components of the HBM contribute to preventive health behavior related to the COVID-19 infection. Results The questionnaire had a reasonable response rate (79.3%, 107 ophthalmologists, including 48 consultants, 51 fellows, and 36 residents). The study demonstrated that this model is useful and mapped how several components were significantly correlated to actions. Most significantly, perceived susceptibility was the most important predictor of action. The second most important determinant of action was the perceived benefit. Conclusion Pandemics such as COVID-19 are likely to happen again in the future. Explicit attention to factors influencing motivation such as threat perception to adopt appropriate health-related behavior to limit the spread of communicable diseases is necessary. This study has successfully represented preparedness and risk behavior perception of ophthalmologists of the novel COVID-19 pandemic in one of the largest tertiary eye hospitals in the Middle East using the Health Belief Model.

5.
Eye Contact Lens ; 47(2): 113-117, 2021 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-33492010

RESUMO

OBJECTIVE: To evaluate the corneal re-epithelialization and patient-perceived pain after bandage contact lens (BCL) exchange on day one, after photorefractive keratectomy (PRK). METHODS: A randomized controlled trial, of all patients who underwent bilateral transepithelial-PRK (trans-PRK) or bilateral alcohol debridement and PRK (A-PRK), between March and October 2019. One eye of each patient was randomly assigned to BCL exchange on the first postoperative day (exchange group) and the BCL was not exchanged in the fellow eye (control group). Patients were evaluated daily until healing was complete. At each visit, the corneal epithelial defect was measured, and a questionnaire was used to assess pain, photophobia, and excessive tearing. P<0.05 was statistically significant. RESULTS: The study sample was comprised of 56 patients (mean age 27.2±5.7 years). Trans-PRK was performed in 20 (34.5%) and A-PRK in 36 (64.3%) patients. At day 3, 40 (71.4%) eyes of the exchange group healed completely compared with 38 (67.9%) eyes of the control group (P=0.5). At day-1 follow-up, the pain score was 1.87±1.4 in the exchange group and 2.29±1.3 in the control group (P=0.009). The mean pain score was 1.58±1.4 among patients who underwent A-PRK and 2.35±1.2 among patients operated by trans-PRK (P=0.04). CONCLUSION: The epithelial healing did not vary when BCL was exchanged one day after refractive surgery. However, postoperative pain score after PRK was lower at day 1, when the BCL was exchanged. Compared with A-PRK, trans-PRK group demonstrated a higher pain score in the early postoperative phase.


Assuntos
Lentes de Contato Hidrofílicas , Epitélio Corneano , Miopia , Ceratectomia Fotorrefrativa , Adulto , Curativos Hidrocoloides , Humanos , Lasers de Excimer/uso terapêutico , Miopia/cirurgia , Dor Pós-Operatória/etiologia
6.
J AAPOS ; 24(1): 25.e1-25.e6, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31923620

RESUMO

PURPOSE: To report the incidence and outcomes of suprachoroidal hemorrhage (SCH) associated with pediatric glaucoma surgery. METHOD: The medical records of pediatric patients (<18 years of age) who had undergone glaucoma surgery and developed SCH from June 2014 to September 2017 were reviewed retrospectively. In all cases, the SCH was suspected clinically and was confirmed by B-scan ultrasound. Baseline characteristics, intraoperative details (including surgery type), and subsequent and final outcomes were extracted from the records. RESULTS: Of 2,656 glaucoma surgeries during the study period, 17 cases of SCH were documented, for an overall incidence of 0.64%. Of the 17 cases, 16 occurred postoperatively, and 1 was noted intraoperatively. By surgery type, the incidence of SCH was highest for trabeculectomy (4/121), followed by glaucoma drainage device surgery (6/463), deep sclerectomy (6/851), and transcleral cyclophotocoagulation (1/542). Four children had received prior transcleral cyclophotocoagulation, and 5 of the children were aphakic at the time of the glaucoma surgery. At a mean final follow-up of 1.71 ± 1.08 years), visual acuity in the affected eye was 20/50 or better in 3 children, between 20/50 and 20/200 in 5 children, and counting fingers or worse in 9 children. CONCLUSIONS: In our study cohort, the overall incidence of SCH associated with glaucoma surgery was 0.64%. Further study of risk factors for SCH associated with glaucoma surgery in children is needed.


Assuntos
Hemorragia da Coroide/epidemiologia , Cirurgia Filtrante/efeitos adversos , Glaucoma/cirurgia , Hemorragia Pós-Operatória/epidemiologia , Acuidade Visual , Adolescente , Criança , Pré-Escolar , Hemorragia da Coroide/diagnóstico , Hemorragia da Coroide/etiologia , Feminino , Humanos , Incidência , Lactente , Recém-Nascido , Masculino , Hemorragia Pós-Operatória/diagnóstico , Hemorragia Pós-Operatória/etiologia , Estudos Retrospectivos , Fatores de Risco , Arábia Saudita/epidemiologia , Ultrassonografia
7.
Saudi J Ophthalmol ; 34(1): 25-29, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33542983

RESUMO

PURPOSE: There has been a recent increase in accidental retinal injuries due to the careless use of handheld laser devices. The scenarios under which these incidents occur suggest a lack of awareness of the sight-threatening hazards of some handheld lasers. This study aimed to assess knowledge of the population to plan awareness programs and establish protective health policies. METHODS: This observational cross-sectional study used a newly-developed, validated, and pilot-tested questionnaire to survey attendees of football matches in Saudi Arabia between September to October 2018. RESULTS: Five-hundred and sixty-nine attendees were surveyed, and 76% of respondents knew laser pointers were harmful and could damage the eye. However, 73% of respondents did not think that the blue laser was dangerous, indicating poor awareness regarding this particular laser. Only 38% knew which ocular structure is most commonly damaged, and 15.6% did not realize that brief exposure can cause vision loss. Females had better knowledge compared to males. Respondents between 25 and 40 years old, females, and married individuals had the highest levels of a positive attitude. There was no statistically significant difference in the mean knowledge score between those in the medical field and other fields (P = 0.5). CONCLUSION: There is an inadequate knowledge of protective measures against handheld lasers. However, there's an overall positive attitude towards spreading awareness about this issue. Yet, targeted awareness campaigns are still needed in addition to more strict government laws to prevent importing or using high-powered handheld laser pointers.

8.
BMC Res Notes ; 8: 642, 2015 Nov 04.
Artigo em Inglês | MEDLINE | ID: mdl-26536861

RESUMO

BACKGROUND: Drug-related problems are prevalent among older patients, and substantially increase the risk of morbidity, (re-)hospitalisation and mortality. To detect drug-related problems and optimize treatment primary caregivers should periodically review the medication of older patients. The aim was to develop a structured, comprehensive but practicable tool to facilitate and support the reviewing of medication of older patients with a chronic disease by pharmacists and general practitioners. METHODS: A tool facilitating clinical medication review by community pharmacists was developed on the basis of treatment guidelines, literature data on drug-related problems. For the identification of drug-related problems from the patient's perspective, a script for structured interviews was developed. The tool was optimized by means of a Delphi method with an expert panel and testing in a trial. RESULTS: The medication review tool consists of a comprehensive checklist of 124 drug-related problems divided by 20 sections according to physiological systems and diseases, and includes a structured interview script for a patient interviews. CONCLUSION: A structured, comprehensive and practical tool to assist pharmacists and general practitioners to perform clinical medication review including a list of potential drug-related problems in older patients with chronic disease, as well as a script for structured patient interviews, was developed.


Assuntos
Técnica Delfos , Clínicos Gerais , Conduta do Tratamento Medicamentoso , Farmacêuticos , Idoso , Lista de Checagem , Humanos , Países Baixos , Saúde Pública/métodos , Reprodutibilidade dos Testes
9.
Patient Prefer Adherence ; 8: 155-65, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24523581

RESUMO

BACKGROUND: Drug-related problems (DRP) following hospital discharge are common among elderly patients using multiple drugs for the treatment of chronic diseases. The aim of this study was to investigate the occurrence of DRP in these patients using a specific tool for the identification of DRP by community pharmacists. METHODS: An observational study involving 340 patients aged over 60 years using at least five prescription drugs and discharged from hospital. The occurrence of DRP was assessed by means of an identification tool specifically developed for use by community pharmacists, including a semistructured patient interview and a checklist of common DRP. RESULTS: In total, 992 potential DRP were observed in the 340 patients (mean 2.9 ± 1.7). No drug prescribed but clear indication, an unnecessarily long duration of treatment, dose too low, and incorrect drug selection were the DRP most commonly observed. Ten percent of DRP occurring in 71 patients were drug-drug interactions. The number of DRP was related to the number of drugs prescribed. Frequently occurring DRP found using the patient interview were fear of side effects and no or insufficient knowledge of drug use. Medication of patients discharged from the pulmonary department and of those with type 2 diabetes was particularly associated with occurrence of DRP. CONCLUSION: Following hospital discharge, DRP occur frequently among elderly patients using five or more drugs for the treatment of chronic disease. The number of DRP increased with the number of drugs used. An important task for community pharmacists is to identify, resolve, and prevent the occurrence of DRP among this patient group. Since DRP are associated with an increased risk of hospital readmissions, morbidity, and mortality, it is very important to develop intervention strategies to resolve and prevent DRP.

11.
Evolution ; 66(4): 1180-95, 2012 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-22486697

RESUMO

The process of speciation is key to the origins of biodiversity, and yet the Caenorhabditis nematode model system has contributed little to this topic. Genetic studies of speciation in the genus are now feasible, owing to crosses between the recently discovered Caenorhabditis sp. 9 and the well-known C. briggsae producing fertile F(1) hybrid females. We dissected patterns of postzygotic reproductive isolation between these species by crossing eight isogenic strains of C. briggsae reciprocally with six strains of C. sp. 9. We determined that overall patterns of reproductive isolation are robust across these genetic backgrounds. However, we also quantified significant heritable variation within each species for interspecific hybrid incompatibilities for total adult progeny, egg-to-adult viability, and the percentage of male progeny. This demonstrates that intraspecific variation for interspecific hybrid incompatibility occurs despite extensive, albeit incomplete, reproductive isolation. Therefore, this emerging general phenomenon of variable reproductive isolation is not restricted to highly interfertile, early-stage incipient species, but also applies to species in the latest stages of the speciation process. Furthermore, we confirm Haldane's rule and demonstrate strongly asymmetric parent-of-origin effects (Darwin's corollary) that consistently manifest more extremely when hermaphroditic C. briggsae serves as maternal parent. These findings highlight Caenorhabditis as an emerging system for understanding the genetics of general patterns of reproductive isolation.


Assuntos
Caenorhabditis/genética , Variação Genética , Isolamento Reprodutivo , Animais , Caenorhabditis/fisiologia , Feminino , Especiação Genética , Hibridização Genética , Masculino , Reprodução
12.
BMC Public Health ; 10: 133, 2010 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-20230611

RESUMO

BACKGROUND: Drug related problems (DRPs) are common among elderly patients who are discharged from the hospital and are using several drugs for their chronic diseases. Examples of drug related problems are contra-indications, interactions, adverse drug reactions and inefficacy of treatment. Causes of these problems include prescription errors and non-compliance with treatment. The aim of this study is to examine the effect of medication review and cognitive behaviour therapy of discharged patients by community pharmacists to minimize the occurrence of drug related problems. METHODS/DESIGN: A randomized controlled trial will be performed. Community pharmacists will be randomized into a control group and an intervention group. 342 Patients, aged over 60 years, discharged from general and academic hospitals, using five or more prescription drugs for their chronic disease will be asked by their pharmacy to participate in the study. Patients randomized to the control group will receive usual care according to the Dutch Pharmacy Standard. The medication of patients randomised to the intervention group will be reviewed by the community pharmacist with use of the national guidelines for the treatment of diseases, when patients are discharged from the hospital. The Pharmaceutical Care network Europe Registration form will be used to record drug related problems. Trained pharmacy technicians will counsel patients at home at baseline and at 1,3,6,9 and 12 months, using Cognitive Behaviour Treatment according to the Theory of Planned Behaviour. The patient's attitude towards medication and patient's adherence will be subject of the cognitive behaviour treatment. The counselling methods that will be used are motivational interviewing and problem solving treatment. Patients adherence towards drug use will be determined with use of the Medication Adherence Report Scale Questionnaire. There will be a follow-up of 12 months.The two primary outcome measures are the difference in occurrence of DRPs between intervention and control group and adherence with drug use. Secondary endpoints are attitude towards drug use, incidence of Re-hospitalisations related to medicines, functional status of the patient, quality of life and the cost-effectiveness of this intervention. DISCUSSION: Combining both medication review and Cognitive Behaviour Treatment may decrease DRPs and may result in more compliance with drug use among patients discharged from the hospital and using 5 or more chronic drugs. TRIAL REGISTRATION: Dutch Trial Register NTR1194.


Assuntos
Terapia Cognitivo-Comportamental , Serviços Comunitários de Farmácia/normas , Aconselhamento/normas , Conduta do Tratamento Medicamentoso , Alta do Paciente/normas , Farmacêuticos , Serviços Preventivos de Saúde/normas , Centros Médicos Acadêmicos , Idoso , Atitude Frente a Saúde , Aconselhamento/educação , Aconselhamento/métodos , Interações Medicamentosas , Feminino , Humanos , Masculino , Erros de Medicação/prevenção & controle , Erros de Medicação/estatística & dados numéricos , Pessoa de Meia-Idade , Cooperação do Paciente/psicologia , Cooperação do Paciente/estatística & dados numéricos , Readmissão do Paciente/estatística & dados numéricos , Farmacêuticos/psicologia , Farmacêuticos/normas , Polimedicação , Transtornos Relacionados ao Uso de Substâncias/prevenção & controle
13.
J Eval Clin Pract ; 15(6): 1125-30, 2009 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-20367715

RESUMO

OBJECTIVES: The level of evidence-based practice (EBP) and awareness has not been previously assessed among primary care physicians in Kuwait. The objectives of this study were to quantify the level of EBP and awareness in Kuwait and identify the factors related to EBP. METHOD: We used a cross sectional study that enrolled 332 primary care physicians in 57 primary care centres randomly chosen in Kuwait. A self-administered questionnaire was used to collect the data with a response rate of about 93%. RESULTS: Although half of the physicians self reported that they use EBP most of the time, further analysis revealed that only about 24% of this group had a reasonable understanding of EBP. Most of the clinical practice in the Kuwaiti primary care system seems to be based on the clinician's own judgment or what they learned in the medical school and traditional text books, rather than evidence-based sources. None of the physicians had an Internet connection at their work place and a vast majority of them had no access to international journals nor were confident about critical appraisal of published evidence. CONCLUSION: Overall level of awareness of evidence-based medicine (EBM) among primary care physicians in Kuwait was considerably low. Training in the areas of EBM as well as making sure the Kuwaiti primary care centres have access to evidence-based sources are critically important if primary care in Kuwait were to become evidence based.


Assuntos
Medicina Baseada em Evidências , Padrões de Prática Médica/estatística & dados numéricos , Atenção Primária à Saúde , Análise de Variância , Intervalos de Confiança , Estudos Transversais , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Kuweit , Inquéritos e Questionários
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