scholarly journals Slit lamp photography for objective assessment of topical eye disorders

2022 ◽  
Vol 7 (4) ◽  
pp. 648-654
Author(s):  
A B Biradar ◽  
Arun Das ◽  
Adeeb A
Keyword(s):  
Objective Assessment ◽  
Smart Phone ◽  
Research Society ◽  
Evidence Based ◽  
Slit Lamp ◽  
Eye Disorders ◽  
Scientific Analysis ◽  
Quantitative Data Analysis ◽  
Clinical Conditions ◽  
Conjunctival Hemorrhage

Evidence based scientific studies has weightage, when they are presented with quantitative data analysis. Documentation and parametric analysis has become an integral part of present day research. Any publications or write-ups without explanation through standard parameters are not appreciated by the research society. In Ophthalmology assessment of various parameters through photography is a debatable issue. Affordability for higher end diagnostic / OPD instruments may not be feasible for all. In such a scenario, here is an attempt made to standardize the slit lamp photography with a smart phone and its scientific analysis for evaluating clinical conditions like sub-conjunctival hemorrhage, etc. This technique can become a tool for assessment and response of the therapies as well as an important tool to seek help from higher centers. Various add-on benefits in research, limitation and scope for further evaluation also being discussed.

Objective assessment of physical activity during chemotherapy for breast cancer.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. TPS6626-TPS6626 ◽  
Author(s):  
Michelle E. Melisko ◽  
Edward Kenji Hadeler ◽  
Sandahl H Nelson ◽  
Audrey Lunde ◽  
Irene Acerbi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Physical Activity ◽  
Objective Assessment ◽  
Smart Phone ◽  
Metastatic Breast ◽  
Activity Levels ◽  
Breast Cancer Patients ◽  
Eligibility Criteria ◽  
Anxiety Depression

TPS6626 Background: Exercise can alleviate side effects of chemotherapy, improve quality of life (QOL), and positively impact disease specific and overall survival. Despite the benefits of physical activity (PA), many patients’ activity levels decrease during chemotherapy. Wearable devices, such as the Fitbit, can provide insight into patterns of activity, and help encourage behavior change. The aims of this study are: 1) determine the feasibility/acceptability of using a Fitbit to measure PA and sleep throughout chemotherapy for breast cancer; 2) describe patterns of PA, sedentary time, and sleep during chemotherapy; 3) explore associations of activity and sleep with QOL. Methods: Non-metastatic breast cancer patients from UCSF and UCSD will be enrolled prior to starting chemotherapy. Eligibility criteria include ability to speak/read English, walk unassisted, and access to internet or Fitbit compatible smart phone. Patients sign informed consent, receive a Fitbit Charge HR and guidance on how to use the device. Patients are instructed to wear the Fitbit throughout their adjuvant or neoadjuvant chemotherapy and 6 months post therapy and to sync the Fitbit at least weekly. Patients complete surveys at start, midpoint, end, and 6 months post chemotherapy. Questionnaires include PROMIS anxiety, depression, physical function, fatigue, cognitive function, social roles, comfort with technology and usefulness of the Fitbit. Fitabase database collects minute level activity, sleep, and heart rate. To assess feasibility, we will evaluate if a participant wears FitBit for at least 10 hour per day for ≥ 80% of the days during chemotherapy. We will use mixed effects regression models to assess patterns of PA and associations between activity and QOL. All models will include activity time and Fitbit wear time and will control for the potential confounding effects of age and other demographic or clinical variables. As of February 6 2017, 48 out of a planned 80 patients are enrolled. Acknowledgment: Athena Breast Health Network investigators and patients; support at UCSD by NCI (U54 CA155435-01) and by gift from Carol Vassiliadis and family; NCI grant K07CA181323 to SH; UCSF M Zion Health Fund Award, GBCTB unrestricted funding and TriValley SOCKS to MM. Clinical trial information: NCT03041545.

The efficacy of telemedicine for ophthalmology triage by a general practitioner

2005 ◽  
Vol 11 (1_suppl) ◽  
pp. 83-85 ◽  
Author(s):  
Alexandre Chater Taleb ◽  
György M Böhm ◽  
Marcos Avila ◽  
Chao Lung Wen
Keyword(s):  
General Practitioner ◽  
Digital Camera ◽  
Brazilian Population ◽  
Slit Lamp ◽  
Face To Face ◽  
Eye Disorders

Although there are enough ophthalmologists for the Brazilian population, they are not evenly distributed throughout the country. Tele-ophthalmology may therefore be a useful tool. We have examined the feasibility of ophthalmology triage, performed by a general practitioner (GP) with remote support from an ophthalmologist. Forty patients with a variety of external and internal eye disorders were examined by the GP and also reassessed by an ophthalmologist, face to face, and then remotely by another ophthalmologist. There was agreement in 95% of the diagnoses between face-to-face and distant evaluation. The use of a digital camera and slit-lamp allowed greater accuracy of telediagnosis than the use of a digital camera alone. The GP would have referred 36 patients to an ophthalmologist, while both the local and the remote ophthalmologist saw the need for referral in 31 cases, i.e. assessment by tele-ophthalmology resulted in a 14% decrease in referrals. GP triage therefore appears to be feasible after appropriate training.

scholarly journals Management of obesity in Scotland: development of the latest evidence-based recommendations

2010 ◽  
Vol 69 (2) ◽  
pp. 195-198 ◽  
Author(s):  
J. Thompson
Keyword(s):  
Young People ◽  
Clinical Excellence ◽  
Evidence Base ◽  
Evidence Based ◽  
Healthy Weight ◽  
Guideline Adaptation ◽  
Lifestyle Measures ◽  
Scottish Government ◽  
Clinical Conditions ◽  
The Cost

The problem of obesity in Scotland has reached epidemic proportions and this reality is recognised at Scottish Government level. The financial impact of treating obesity and obesity-related disease is substantial and in Scotland the cost was estimated at £171×106 in 2001 but only a small proportion of this estimate included weight-loss interventions. The Scottish Intercollegiate Guidelines Network (SIGN) define clinical guidelines as ‘systematically developed statements to help practitioner and patient decisions’ that ‘provide recommendations for effective practice in the management of clinical conditions where variations in practice are known to occur and where effective care may be known not to occur’. The evidence base for successful interventions has progressed since the publication by SIGN of Obesity in Scotland: Integrating Prevention with Weight Management in 1996 and Management of Obesity in Children and Young People in 2003. In 2007 SIGN commissioned a review of these two publications. In 2006 the National Institute for Health and Clinical Excellence (NICE) published a comprehensive obesity guideline and to avoid duplication of effort SIGN used the ADAPTE guideline adaptation framework to utilise and update evidence tables produced by NICE (where appropriate) as a basis for considered judgement. The new SIGN guideline is due for publication in 2010 and addresses children, young people (<18 years old) and adults. It will provide evidence-based recommendations on primary prevention of obesity (defined as intervention when individuals are at a healthy weight and/or overweight to prevent or delay the onset of obesity) within the clinical setting and treatment by lifestyle measures, drugs and surgery.

scholarly journals Evidence-Based Management of Gout - A Systematic Search and Review

2020 ◽  
Author(s):  
Md Abu Bakar Siddiq
Keyword(s):  
Risk Factors ◽  
Treatment Options ◽  
Evidence Based ◽  
Level Of Evidence ◽  
Pharmacological Agents ◽  
New Synthesis ◽  
Pubmed Database ◽  
Anti Inflammatory ◽  
Clinical Conditions

Gout is the most common form of inflammatory arthritis. Hyperuricaemia is the pre-requisite for gout and is influenced by variable modifiable and non-modifiable risk factors. Clinical features unique for gout are due to deposition of monosodium urate (MSU) crystal in articular and extra articular tissues. Among various treating agents, anti-inflammatory drugs and urate lowering therapies (ULT) are used widely and successfully, however, non-medicinal means are also effective in the disorder. In their updated guidelines, ACR (2012) and EULAR (2016) recommended both medicinal and non-medicinal approaches that could be used in treating gout, though some of the recommendations are based on lower level of evidence. Moreover, researchers&rsquo; continued effort in finding new gout managing agents appear promising, for example, role of Lesinurad in gout management (CLEAR1, CLEAR2). In this new synthesis the author is aimed to provide updated information on gout management based on a systematic review including published work within last ten years between 2008 and 2018 and for this purpose, using &lsquo;clinical trials in gout management&rsquo; string, published worked searched in PubMed database from 1st September 2018 to 30 October 2018. Besides the recent ACR and EULAR evidence based management guidelines, the author reviewed another 91 (total 93) articles to make this new draft &ndash; 39 articles describe role of pharmacological agents and 54 describe different gout risks, pharmacokinetics/pharmacodynamics of ULT, association between raised sUA level and renal impairment, efficacy of non-pharmacological agents in reducing sUA. According to published work, anti-inflammatory agent is the most appropriate drug group in mitigating inflammatory symptoms of gout, though they often adversely affect over other vital 2 organs with impaired function. Besides ULT, uricase analogues are also found useful in non refractory gout. Since anti-inflammatory agents and ULT contraindicate in some clinical conditions, intra-articular steroid and or adrenocorticotropic hormone (ACTH) are appropriate alternatives instead. However, head-to-head comparison between different NSAIDs, NSAID and prednisolone, NSAID and colchicine are yet to perform. Use of combined anti-inflammatory preparations in gout is also based on lower level of evidence. Regarding effective maximum dose and long-standing impact of ULT on vital organs we are yet to reach a conclusion. Likewise, non-medicinal approaches are widely using in achieving target sUA level, though some of them are based on biased study outcomes and or study with inadequate power, requiring further analysis. Among non-pharmacological approaches, life-style modification, restriction of purine rich diets, avoidance of gout inciting agents are important, but inconclusive. Educating patients&rsquo; about diseases, risk factors, available treatment options and side effects from them are also important in terms of achieving sUA level, nevertheless too much counseling sometimes could be worthless.

scholarly journals Evaluation of Pancreatotropic and Joint Efficiency of Intracellular Systemic Enzyme in Osteoarthritis

2021 ◽  
pp. 66-69
Author(s):  
Liliia Babynets ◽  
Iryna Halabitska
Keyword(s):  
Objective Assessment ◽  
Pancreatic Insufficiency ◽  
Study Groups ◽  
Exocrine Pancreatic Insufficiency ◽  
Evidence Based ◽  
Unresolved Issue ◽  
Orthopedic Surgeons ◽  
European League Against Rheumatism ◽  
Based Medicine ◽  
European League

Despite the advances of modern evidence-based medicine, the treatment of osteoarthritis (OA) remains a complex and unresolved issue. Of course, modification of the patient’s lifestyle improves the condition of a patient with osteoarthritis, but the management of a patient with osteoarthritis without drug therapy, which is mostly symptomatic, is almost impossible. The objective: was to investigate the effectiveness of intracellular systemic enzyme in the complex therapy of patients with primary OA in comorbidity with exocrine pancreatic insufficiency for the correction of pathological processes developing in patients. Materials and methods. 69 patients with primary OA in comorbidity with exocrine pancreatic insufficiency were examined. The diagnosis of OA was established on the basis of diagnostic criteria of the American College of Rheumatologists (ACR, 2018), the European Association of Rheumatologists (European League Against Rheumatism, EULAR, 2018). American Academy of Orthopedic Surgeons (AAOS, 2018), International Society for the Study of OA (OARSI, 2019). Examination of the joints included examination, palpation, and objective assessment of pain. OA symptoms were also assessed by Leken index and the Harris test. To assess the state of exocrine pancreatic insufficiency, the content of fecal α-elastase was determined and the coprogram was evaluated. Patients were divided into two groups: the 1st group received treatment of primary OA according to international recommendations, the 2nd group additionally received an enzymatic drug. Results. After the treatment, patients of the 1st group showed a statistically significant tendency to deterioration of fecal α-elastase and coprogram (p<0,05), in the 2nd group there was a statistically significant improvement of these indicators (p<0,05). There was also a statistically significant improvement in the course of primary OA in both study groups (p<0,05), but in the 2nd group the therapeutic effect was statistically significantly more significant (p<0,05). Conclusions. There was a statistically significant positive dynamics of exocrine pancreatic insufficiency and course of primary OA in the 2nd group compared to those in the 1st after treatment (p<0,05), which indicates the feasibility of using the enzyme drug in the treatment of patients with primary OA in comorbidity with exocrine pancreatic insufficiency.

About Some Measures for Autonomization and Optimization of Administrative and Tort Proceedings in the Russian Federation

2021 ◽  
Vol 3 ◽  
pp. 13-23
Author(s):  
А.I. Stakhov ◽  
Keyword(s):  
Russian Federation ◽  
Judicial Reform ◽  
Evidence Based ◽  
Supervisory Relationship ◽  
Scientific Analysis ◽  
Tort Litigation ◽  
The Russian Federation ◽  
Administrative Code ◽  
Administrative Proceedings ◽  
And Control

The article reveals the problems that unite the judicial reform with the reform of the Institute of administrative responsibility and control and Supervisory activities, which are currently being carried out in the Russian Federation in parallel. In this regard, the research focuses on the key connecting element of these reforms, namely: administrative torts detected in the course of control and Supervisory activities. Presents the scientific analysis allows to understand the administrative-procedural content of control and supervision, to justify the separation of this state activities for centralized and decentralized types, to allocate the administrative and disposable administratrative punishable offences entailing the use of complex special administrative coercive measures extrajudicial and judicial administrative and procedural matters to make the conclusion about the necessity of separating judicial and administrative tort cases arising from the Supervisory relationship, among the total number of administrative cases assigned to the jurisdiction of the courts. In strict accordance with the principles and norms of the Constitution of the Russian Federation, autonomy is justified (separation in judicial administrative proceedings) administrative and tort proceedings. The ranking of administrative and tort proceedings on the main and derivative types is carried out, the consolidation is justified) punitive and restorative administrative and tort proceedings. Conducted a comprehensive review of administrative tort proceedings, enshrined in the APC, СAP and Administrative Code. The results of the analysis put forward evidence-based conceptual proposals on optimization of administrative-tort litigation, which can be implemented in the course of the country's judicial reform in conjunction with reform of legislation on administrative offences and regulatory activities.

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