Ophthalmology

2018 ◽  
Author(s):  
Venki Sundaram
Keyword(s):  
Visual Recognition ◽  
Medical Knowledge ◽  
The Elderly ◽  
Good Communication ◽  
Ocular Manifestations ◽  
Eye Problems ◽  
Hand Eye Coordination ◽  
Patient Groups ◽  
Surgical Conditions ◽  
Medical Teams

Ophthalmology principally aims to prevent visual loss, restore visual function, and relieve ocular discomfort. The majority of the pathology can be directly visualized and thus requires proficient ocular examination techniques and visual recognition skills. Another distinguishing aspect of ophthalmology is the overlap between medical and surgical conditions. Common systemic diseases such as diabetes and hypertension have ocular features, and diseases involving every organ of the body can have ocular manifestations. A thorough medical knowledge is paramount, as is the ability to collaborate with other medical teams. Intraocular surgery for conditions such as cataract is technically challenging, as ocular tissues are so delicate. It therefore requires high levels of fine hand–eye coordination. As an ophthalmologist, you will be faced both with acute eye conditions, some of which are sight-threatening and require prompt diagnosis and management, and with chronic conditions, which require monitoring and treatment for many years. You will be exposed to patients of all ages, from premature babies to the elderly, so good communication with a wide range of patient groups and their families is essential. Patients often say that what they fear most is losing their sight. Therefore, empathy and support for patients with debilitating visual impairment are imperative. The questions in this chapter will test your knowledge of acute emergency ophthalmic presentations and the understanding and interpretation of ophthalmic examination, as well as ocular conditions that have systemic associations. In addition, questions relating to ophthalmic risk factors, communication, and probity are included. Eye problems can be daunting to many medical students and doctors. Through practice in examining patients and recognizing key conditions, confidence can be gained in how best to manage these patients and, importantly, when to refer them to other specialties. Ophthalmology incorporates a unique and appealing mix of medical and surgical conditions. It is a rapidly advancing specialty with recent significant advances in diagnostic and therapeutic options. It also provides an opportunity for a good work–life balance.

scholarly journals Surgical Decisions in the Elderly: The Importance of Biological Age

2001 ◽  
Vol 94 (5) ◽  
pp. 232-235 ◽  
Author(s):  
S M Farquharson ◽  
Ramesh Gupta ◽  
R J Heald ◽  
B J Moran
Keyword(s):  
Elderly Patients ◽  
Medical History ◽  
Surgical Management ◽  
The Elderly ◽  
Biological Age ◽  
Star Rating ◽  
Patient Groups ◽  
Surgical Conditions ◽  
The One ◽  
Independent Existence

Summary Surgeons will sometimes advise against an operation because the patient is ‘old and frail’. A simple starring system (one to five), based on performance and lifestyle, has been devised to assess the biological age of elderly patients. 10 consultant surgeons and 10 trainees answered questions about their treatment recommendations for hypothetical patients of standard age and medical history but with various star ratings and surgical conditions. 1000 decisions were available for analysis. The four and five star patients (those leading an independent existence) were recommended 266 interventions, the one and two star patients 55. Trainees were more inclined to intervene than consultants, recommending operations in half the patients rather than one-third. These results indicate that decisions on surgical management are strongly influenced by the patient's star rating or biological age. If the starring method proves reproducible in other patient groups and settings, it could allow better communication on an important factor in clinical decisions.

An Informant Questionnaire for Detecting Alzheimer's Disease: Are Some Items Better Than Others?

2011 ◽  
Vol 17 (4) ◽  
pp. 674-681 ◽  
Author(s):  
Sietske A.M. Sikkes ◽  
Dirk L. Knol ◽  
Mark T. van den Berg ◽  
Elly S.M. de Lange-de Klerk ◽  
Philip Scheltens ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Structural Equation ◽  
Structural Model ◽  
The Elderly ◽  
Equation Modeling ◽  
Or Education ◽  
Healthy Elderly ◽  
Patient Groups ◽  
Better Than

AbstractA decline in everyday cognitive functioning is important for diagnosing dementia. Informant questionnaires, such as the informant questionnaire on cognitive decline in the elderly (IQCODE), are used to measure this. Previously, conflicting results on the IQCODEs ability to discriminate between Alzheimer's disease (AD), mild cognitive impairment (MCI), and cognitively healthy elderly were found. We aim to investigate whether specific groups of items are more useful than others in discriminating between these patient groups. Informants of 180 AD, 59 MCI, and 89 patients with subjective memory complaints (SMC) completed the IQCODE. To investigate the grouping of questionnaire items, we used a two-dimensional graded response model (GRM).The association between IQCODE, age, gender, education, and diagnosis was modeled using structural equation modeling. The GRM with two groups of items fitted better than the unidimensional model. However, the high correlation between the dimensions (r=.90) suggested unidimensionality. The structural model showed that the IQCODE was able to differentiate between all patient groups. The IQCODE can be considered as unidimensional and as a useful addition to diagnostic screening in a memory clinic setting, as it was able to distinguish between AD, MCI, and SMC and was not influenced by gender or education. (JINS, 2011, 17, 674–681)

scholarly journals The Art of Surgery: Balancing Compassionate With Virtual Care (Preprint)

2020 ◽  
Author(s):  
Elisheva Tamar Anne Nemetz ◽  
David Robert Urbach ◽  
Karen Michelle Devon
Keyword(s):  
Health Care ◽  
Physical Examination ◽  
Health Care Team ◽  
Body Language ◽  
Surgical Practice ◽  
Good Communication ◽  
Academic Literature ◽  
Virtual Care ◽  
Patient Groups

UNSTRUCTURED The recent drive to include virtual care in surgical practice has been accelerated due to the COVID-19 pandemic. Many physicians feel that communicating via telehealth is unlike traditional methods of providing health care, and thus guidance on maintaining excellence in communication is necessary, especially as academic literature on virtual care in surgery is nonexistent. Challenges faced in transitioning to virtual care include the inability to utilize body language, barriers to traditional physical examination, exacerbation of existing vulnerabilities and inequities in patient groups, the declining quality of medical education, and the fragmentation of the multidisciplinary health care team. This paper seeks to resolve these challenges by focusing on the pillars of good communication, including preparation, professionalism, empathy, respect, and the virtual physical examination.

The Brixton Spatial Anticipation Test as a test for executive function: Validity in patient groups and norms for older adults

2009 ◽  
Vol 15 (5) ◽  
pp. 695-703 ◽  
Author(s):  
ESTHER VAN DEN BERG ◽  
GUDRUN M. S. NYS ◽  
AUGUSTINA M. A. BRANDS ◽  
CARLA RUIS ◽  
MARTINE J. E. VAN ZANDVOORT ◽  
...  
Keyword(s):  
Executive Functioning ◽  
Psychiatric Disorders ◽  
Neuropsychological Tests ◽  
Normative Data ◽  
The Elderly ◽  
Learning Effects ◽  
Korsakoff’S Syndrome ◽  
Early Dementia ◽  
Korsakoff's Syndrome ◽  
Patient Groups

AbstractImpairments in executive functioning frequently occur after acquired brain damage, in psychiatric disorders, and in relation to aging. The Brixton Spatial Anticipation Test is a relatively new measure for assessing the ability to detect and follow a rule, an important aspect of executive functioning. To date, normative data on this task are limited, particularly concerning the elderly. This study presents age- and education-adjusted regression-based norms obtained in a group of healthy older participants (n = 283; mean age 67.4 ± 8.5 years). The applicability and validity of these norms were further examined in different groups of patients with stroke (n = 106), diabetes mellitus (n = 376), MCI/early dementia (n = 70), psychiatric disorders (n = 63), and Korsakoff’s syndrome (n = 41). The results showed that patients with Korsakoff’s syndrome, stroke, and psychiatric disorders performed significantly worse than healthy controls. Test-retest correlation (n = 83), learning effects, and correlations with other neuropsychological tests were also explored. Based on the present study, the Brixton test appears a useful addition to existing measures of executive functioning. Moreover, the test can be reliably applied in different groups of clinical patients. (JINS, 2009, 15, 695–703.)

scholarly journals COVID-19: when, along with aging, sex matters

2020 ◽  
Vol 6 (4) ◽  
Author(s):  
Virginia Boccardi ◽  
Patrizia Mecocci
Keyword(s):  
Innate Immunity ◽  
Severe Acute Respiratory Syndrome ◽  
Older Women ◽  
Steroid Hormones ◽  
Older Persons ◽  
Viral Infections ◽  
The Elderly ◽  
The Novel ◽  
Age Related ◽  
Patient Groups

Older persons are more susceptible to infection due to the age-related immunologic changes and the state of constitutive lowgrade inflammation. The rate of complications from the novel severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) and its related coronavirus disease 2019 (COVID-19), is significantly higher in the elderly, with men as the most affected. It is known that women, in general, are less susceptible to viral infections complications thanks to three main differences in sex chromosomes, innate immunity, and steroid hormones. COVID-19 epidemiology in Italy further support that older women, even if frailer, may experience lower mortality than men, which extends the ‘male-female health-survival paradox’ to acutely ill patient groups.

scholarly journals Basic Study for New Assistive Technology Based on Brain Activity During Car Driving

2014 ◽  
Vol 26 (2) ◽  
pp. 253-260 ◽  
Author(s):  
Shunji Shimizu ◽  
◽  
Hiroaki Inoue ◽  
Hiroyuki Nara ◽  
Takeshi Tsuruga ◽  
...  
Keyword(s):  
Dorsolateral Prefrontal Cortex ◽  
Visual Recognition ◽  
Near Infrared ◽  
Brain Activity ◽  
The Elderly ◽  
Basic Study ◽  
Assistive Robots ◽  
Dorsolateral Prefrontal ◽  
The Relationship ◽  
Car Driving

The purpose of this research is develop assistive robots and apparatuses. There is a pressing need to develop new systems that assist and act for car driving and wheelchairs for the elderly as the population ages. In developing systems, it is thought to be important to examine behaviors spatial recognition. Experiments have therefore been performed to examine human spatial perceptions, especially left- and rightside visual recognition, while cars being driven using near-infrared spectroscopy (NIRS). Previous research found significant differences in the dorsolateral prefrontal cortex in the left cranial hemisphere during virtual driving and actual driving tasks. This paper discusses the measurement of brain activity during car driving. A detailed analysis was performed by segmentalizing brain activity during driving based on the motion of subjects, and we report on the relationship between brain activity and movement perception during driving.

scholarly journals Cervical Spine Trauma

2019 ◽  
Vol 1 (2) ◽  
Author(s):  
Rully Hanafi Dahlan ◽  
Sevline Estethia Ompusunggu ◽  
Ismail M. Baselim ◽  
Yustinus Robby B. G.
Keyword(s):  
Traumatic Brain Injury ◽  
Traffic Accidents ◽  
The Elderly ◽  
Trauma Patients ◽  
Cervical Spine Trauma ◽  
Radiological Imaging ◽  
Spine Trauma ◽  
Cervical Trauma ◽  
Permanent Disability ◽  
Patient Groups

Cervical trauma is a serious condition, that may cause permanent disability or even death. Cervical trauma occurs in 2-7% of blunt trauma patients. In Europe, the incidence of cervical trauma is approximately 9-17/100,000 annually,. The most common mechanisms of injury causing cervival trauma are traffic accidents and falls, which the most commonly injured vertebra is vertebral C2 (axis). Diagnostics of cervical trauma are based on good clinical assessment and prompt radiological imaging. Several patient groups, such as the elderly and patients with traumatic brain injury are highly susceptible to cervical trauma. The diagnostics of cervivcal trauma remain challenging for clinical practitioners and failure to diagnose cervical trauma in acute care may have serious consequences.

Pattern of Eye Problems of the Elderly in a Nigerian Tertiary Health Institution.

2008 ◽  
Vol 51 (3) ◽  
Author(s):  
I S Abdulraheem ◽  
F G Adepoju ◽  
A G Salaudeen ◽  
A A Akanbi
Keyword(s):  
The Elderly ◽  
Health Institution ◽  
Eye Problems

Cognitive Rigidity in the Aged and the Mentally Retarded

1979 ◽  
Vol 9 (3) ◽  
pp. 263-272 ◽  
Author(s):  
N. H. Kirby ◽  
T. Nettelbeck ◽  
S. Goodenough
Keyword(s):  
Older Persons ◽  
Visual Recognition ◽  
Recognition Task ◽  
Mentally Retarded ◽  
The Elderly ◽  
Young Group ◽  
Elderly Group ◽  
Stimulus Material ◽  
Cognitive Rigidity

Three groups, one of elderly, one of young mentally retarded, and one of non-retarded young persons were compared on a visual recognition task which involved changing from one category of identification to another. The mentally retarded participants had greater difficulty in changing categories than did the non-retarded participants. Results for the elderly were similar but may have been partly due to the choice of stimulus material. In a second task, the same elderly and non-retarded young participants named as many objects as possible in one minute. The elderly group produced fewer responses on average than the young group and fewer categories of such responses. Results suggested that older persons find it more difficult to change between different categories of identification.

scholarly journals The Description of Quality of Life of Elderly During the Pandemic COVID-19 at Nursing Home of Bondowoso

2021 ◽  
Vol 1 (3) ◽  
pp. 231-236
Author(s):  
Yahtarita ulfia Adisiwi ◽  
Latifa Aini Susumaningrum ◽  
Tantut Susanto ◽  
Hanny Rasni ◽  
Fahruddin Kurdi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Nursing Home ◽  
Social Relations ◽  
Quantitative Research ◽  
Sampling Technique ◽  
The Elderly ◽  
Self Report ◽  
P Value ◽  
Good Communication

During the COVID-19 pandemic, the elderly were required to reduce direct interactions with people around them. So that, it affected the psychological condition and social relations of the elderly which caused a decrease in their quality of life (QOL). This study aimed to analyze the QOL among elders during the pandemic COVID-19 at the Nursing Home of Bondowoso. The method used in this study was quantitative research with a descriptive design conducted at the Nursing Home of Bondowoso from April until May 2021. 48 elders participated in this study selected by consecutive sampling technique. Data were collected through self-report interviews using a self-administered questionnaire used to identify characteristics of the elderly and WHOQOL-BREF to identify their QoL. The one-sample Kolmogorov-Smirnov's test was used to reach the aim of this study. The result showed that the QOL among elders during the COVID-19 pandemic underwent a significant with Md(25-75)=50(44-52); Z=0,152; p-value 0,007. It can be concluded that the QOL of elders during COVID-19 underwent a significant Quality of life and the majority of elderly experience moderate QOL. Therefore, to improve the QOL, the elderly must maintain good communication with others, and conduct regular physical activity.

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