scholarly journals Difference in Pupillary Diameter as an Important Factor for Evaluating Amplitude of Accommodation: A Prospective Observational Study

2020 ◽  
Vol 9 (8) ◽  
pp. 2678
Author(s):  
Miyuki Kubota ◽  
Shunsuke Kubota ◽  
Hidenaga Kobashi ◽  
Masahiko Ayaki ◽  
Kazuno Negishi ◽  
...  
Keyword(s):  
Prospective Observational Study ◽  
Crystalline Lens ◽  
Visual Display ◽  
Medical Intervention ◽  
Healthy Individuals ◽  
Pupillary Diameter ◽  
Early Medical Intervention ◽  
Treatment Target ◽  
Corrected Visual Acuity ◽  
The Difference

Presbyopia is increasing globally due to aging and the widespread use of visual display terminals. Presbyopia is a decrease in the eye’s amplitude of accommodation (AA) due to loss of crystalline lens elasticity. AA differs widely among individuals. We aimed to determine the factors that cause presbyopia, other than advanced age, for early medical intervention. We examined 95 eyes of 95 healthy volunteers (33 men, 62 women) aged 22–62 years (mean: 37.22 ± 9.77 years) with a corrected visual acuity of ≥1.0 and without other eye afflictions except ametropia. Subjective refraction, AA, maximum and minimum pupillary diameters during accommodation, axial length of the eye, and crystalline lens thickness were measured. AA was measured using an auto refractometer/keratometer/tonometer/pachymeter. The difference between maximum and minimum pupillary diameters was calculated. On multiple regression analysis, age and difference in pupillary diameter were both significantly and independently associated with AA in participants aged <44 years, but not in those aged ≥45 years. Our results suggest that the difference in pupillary diameter could be an important age-independent factor for evaluating AA in healthy individuals without cataract. Thus, improving the difference in pupillary diameter values could be an early treatment target for presbyopia.

Comparison of the Effectiveness of Intravitreal Ranibizumab for Diabetic Macular Edema in Vitrectomized and Nonvitrectomized Eyes

2016 ◽  
Vol 236 (2) ◽  
pp. 67-73 ◽  
Author(s):  
Yoshito Koyanagi ◽  
Shigeo Yoshida ◽  
Yoshiyuki Kobayashi ◽  
Yuki Kubo ◽  
Muneo Yamaguchi ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Treatment Option ◽  
Central Macular Thickness ◽  
Intravitreal Ranibizumab ◽  
Corrected Visual Acuity ◽  
The Mean ◽  
The Difference ◽  
Best Corrected Visual Acuity

Purpose: To compare the effectiveness of intravitreal ranibizumab (IVR) for diabetic macular edema (DME) between eyes with and without previous vitrectomy. Procedures: We prospectively assessed the best-corrected visual acuity (BCVA) and central macular thickness (CMT) after IVR for 6 months. Results: There were no significant differences in the baseline BCVA and CMT between both groups. In the nonvitrectomized group (n = 15), the mean changes of BCVA and CMT from baseline to month 6 were significant (p < 0.01). In the vitrectomized group (n = 10), the improvement appeared to be slower, and the mean BCVA improvement was not significant (p = 0.5), although the mean CMT decrease was significant (p < 0.05). There were no significant differences in the mean changes of BCVA and CMT between both groups at 6 months. Conclusions: The difference in the effectiveness of IVR between both groups was not significant. IVR can be a treatment option even for vitrectomized DME eyes.

scholarly journals Osteonecrosis of the Femoral Head in Patients with Hypercoagulability—From Pathophysiology to Therapeutic Implications

2021 ◽  
Vol 22 (13) ◽  
pp. 6801
Author(s):  
Elena Rezus ◽  
Bogdan Ionel Tamba ◽  
Minerva Codruta Badescu ◽  
Diana Popescu ◽  
Ioana Bratoiu ◽  
...  
Keyword(s):  
Femoral Head ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Medical Intervention ◽  
Rapid Progression ◽  
Anticoagulant Treatment ◽  
Early Medical Intervention ◽  
Therapeutic Implications ◽  
Early Stages ◽  
Hereditary Thrombophilia

Osteonecrosis of the femoral head (ONFH) is a debilitating disease with major social and economic impacts. It frequently affects relatively young adults and has a predilection for rapid progression to femoral head collapse and end-stage hip arthritis. If not diagnosed and treated properly in the early stages, ONFH has devastating consequences and leads to mandatory total hip arthroplasty. The pathophysiology of non-traumatic ONFH is very complex and not fully understood. While multiple risk factors have been associated with secondary ONFH, there are still many cases in which a clear etiology cannot be established. Recognition of the prothrombotic state as part of the etiopathogeny of primary ONFH provides an opportunity for early medical intervention, with implications for both prophylaxis and therapy aimed at slowing or stopping the progression of the disease. Hereditary thrombophilia and hypofibrinolysis are associated with thrombotic occlusion of bone vessels. Anticoagulant treatment can change the natural course of the disease and improve patients’ quality of life. The present work focused on highlighting the association between hereditary thrombophilia/hypofibrinolysis states and ONFH, emphasizing the importance of identifying this condition. We have also provided strong arguments to support the efficiency and safety of anticoagulant treatment in the early stages of the disease, encouraging etiological diagnosis and prompt therapeutic intervention. In the era of direct oral anticoagulants, new therapeutic options have become available, enabling better long-term compliance.

CDH1 germline mutations in healthy individuals from families with the hereditary diffuse gastric cancer syndrome

2021 ◽  
pp. jmedgenet-2021-108226
Author(s):  
Giovanni Corso ◽  
Francesca Magnoni ◽  
Giulia Massari ◽  
Cristina Maria Trovato ◽  
Alessandra Margherita De Scalzi ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Healthy Subjects ◽  
Relevant Literature ◽  
Germline Mutations ◽  
Hereditary Diffuse Gastric Cancer ◽  
Diffuse Gastric Cancer ◽  
Missense Mutations ◽  
Healthy Individuals ◽  
Cancer Syndrome ◽  
The Difference

The objective of this study was to determining the frequency of different sub-types of pathogenic CDH1 germline mutations in healthy and asymptomatic individuals from families with the hereditary diffuse gastric cancer (HDGC) syndrome. Relevant literature dating from 1998 to 2019 was systematically searched for data on CDH1 germline mutations. The collected variants were classified according to their subtype into the following classes: missense, non-sense, splicing, insertions and deletions. The χ2 test was used to estimate if the difference observed between patients with gastric cancer (GC) and unaffected individuals was statistically significant. CDH1 genetic screening data were retrieved for 224 patients with GC and 289 healthy individuals. Among the subjects that had tested CDH1 positive, splicing mutations were found in 30.4% of the healthy individuals and in 15.2% of the patients with GC (p=0.0076). Missense mutations were also found to occur in healthy subjects with higher frequency (22.2%) than in GC-affected individuals (18.3%), but the difference was not significant in this case. In families meeting the clinical criteria for the HDGC syndrome, CDH1 splicing and missense germline mutations have been reported to occur with higher frequency in healthy subjects than in patients with cancer. This preliminary observation suggests that not all pathogenic CDH1 germline mutations confer the same risk of developing GC.

scholarly journals The effect of a secondary task on identification accuracy of oxygen saturation ranges using an enhanced pulse oximetry sonification

2016 ◽  
Vol 60 (1) ◽  
pp. 628-632
Author(s):  
Estrella Paterson ◽  
Penelope Sanderson ◽  
Neil Paterson ◽  
David Liu ◽  
Robert Loeb
Keyword(s):  
Oxygen Saturation ◽  
Secondary Task ◽  
Ambient Noise ◽  
Visual Display ◽  
Identification Accuracy ◽  
Future Research ◽  
Identification Performance ◽  
Arithmetic Task ◽  
Disruption Effect ◽  
The Difference

In the operating theatre, anesthesiologists monitor an anesthetized patient’s oxygen saturation (SpO2) with a visual display but also with an auditory tone, or sonification. However, if the anesthesiologist must divide their attention across tasks, they may be less effective at recognising their patient’s SpO2 level. Previous research indicates that a sonification enhanced with additional sound dimensions of tremolo and brightness more effectively supports participants’ identification of SpO2 ranges than a conventional sonification does. This laboratory study explored the effect of a secondary task on participants’ ability to identify SpO2 range when using a conventional sonification (LogLinear sonification) versus an enhanced sonification (Stepped Effects sonification). Nineteen non-clinician participants who used the Stepped Effects sonification were significantly more effective at identifying SpO2 range ( Md = 100%) than were 18 participants using the LogLinear sonification ( Md = 80%). Range identification performance of participants using the Stepped Effects sonification tended to be less disrupted by a concurrent arithmetic task (drop from Md = 100% to 95%) than it was for participants using the LogLinear sonification (drop from Md = 80% to 73%). However, the disruption effect in each case was small, and the difference in disruption across sonifications was not statistically significant. Future research will test the sonifications under more intense cognitive load and in the presence of ambient noise.

scholarly journals The effect of amblyopia on clinical outcomes of children with astigmatism

2021 ◽  
Vol 13 ◽  
pp. 251584142110408
Author(s):  
Burçin Çakır ◽  
Nilgün Özkan Aksoy ◽  
Sedat Özmen ◽  
Özlem Bursalı
Keyword(s):  
Visual Acuity ◽  
Clinical Outcomes ◽  
Medical Records ◽  
Convergence Insufficiency ◽  
Corrected Visual Acuity ◽  
Ocular Deviation ◽  
The Mean ◽  
The Difference ◽  
Best Corrected Visual Acuity

Background: Amblyopia is more common in children with high astigmatism, but factors contributing to development of amblyopia and visual outcomes are not fully understood. Objective: To evaluate the effect of amblyopia on the clinical outcomes in children with ⩾1.75 diopter (D) astigmatism. Methods: We reviewed the medical records of children with ⩾1.75 D astigmatism with and without amblyopia (amblyopes group and non-amblyopes group). The mean age, gender, amount and type of ocular deviation, presence of convergence insufficiency (CI), stereopsis, time of initial spectacle use and follow-up time, differences in best-corrected visual acuity (VoD) and spherical equivalent (SE) between eyes were assessed and compared between the groups. Best-corrected visual acuity (BCVA), mean SE, astigmatism measurements were assessed and compared between amblyopic, fellow, and non-amblyopic eyes. Results: The records included 68 eyes of 34 children with amblyopia and 56 eyes of 28 children without amblyopia. The mean age, gender, amount and type of ocular deviation, presence of CI, stereopsis, time of initial spectacle use, follow-up time, and the difference in SE did not differ between groups. In amblyopes, exodeviation was more common and statistically greater in near (33 cm) than at distance (6 m) (p = 0.005). The mean BCVA and astigmatism values were statistically different between amblyopic, fellow, and non-amblyopic eyes. Conclusion: A greater near than distance exodeviation and higher mean astigmatism value were found in amblyopic children with astigmatism.

scholarly journals Clinical Efficacy of Novel Patient-Covering Negative-Pressure Box for Shielding Virus Transmission during Esophagogastroduodenoscopy: A Prospective Observational Study

Diagnostics ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. 1679
Author(s):  
Shintaro Fujihara ◽  
Hideki Kobara ◽  
Noriko Nishiyama ◽  
Naoya Tada ◽  
Kazuhiro Kozuka ◽  
...  
Keyword(s):  
Negative Pressure ◽  
Prospective Observational Study ◽  
Preventive Measures ◽  
Virus Transmission ◽  
Preventive Effect ◽  
Degree Of Contamination ◽  
Cutoff Value ◽  
Before And After ◽  
Particle Counts ◽  
The Difference

Esophagogastroduodenoscopy (EGD) has a high risk of virus transmission during the current coronavirus disease 2019 era, and preventive measures are under investigation. We investigated the effectiveness of a newly developed patient-covering negative-pressure box system (Endo barrier®) (EB) for EGD. Eighty consecutive unsedated patients who underwent screening EGD with EB use were prospectively enrolled. To examine the aerosol ratio before, during, and after EGD, 0.3- and 0.5-μm aerosols were measured every 60 s using an optical counter. Moreover, the degree of contamination of the examiners’ goggles and vinyl gowns was assessed before and after EGD using a rapid adenosine triphosphate (ATP) test for simulated droplets. Data were available in 73 patients and showed that 0.3- and 0.5-μm particles did not increase in 95.8% (70/73) and 94.5% (69/73) of patients during EGD under EB. There were no significant differences in the total 0.3- or 0.5-μm particle counts before versus after EGD. The difference in the ATP levels before and after EGD was −0.6 ± 16.6 relative light units (RLU) on goggles and 1.59 ± 19.9 RLU on gowns (both within the cutoff value). EB use during EGD may provide a certain preventive effect against aerosols and droplets, decreasing examiners’ exposure to viruses.

scholarly journals Analyzing the use of linking words in concept maps designed for pathophysiology learning in medicine

2021 ◽  
Author(s):  
Nuno Neuparth ◽  
Marta Fonseca ◽  
Beatriz Oliveira ◽  
Inês Canha ◽  
Hélder Dores ◽  
...  
Keyword(s):  
Concept Mapping ◽  
Concept Maps ◽  
Clinical Case ◽  
Visual Display ◽  
Rank Test ◽  
Clinical Vignettes ◽  
Signed Rank ◽  
Signed Rank Test ◽  
The Difference

Pathophysiology at NOVA Medical School adopted the concept mapping methodology to promote the visual display of pathophysiological reasoning and learning, based on clinical vignettes. The objective of this project is to identify and label the linking words, in order to study their role in the structure and organization of the concept maps constructed by the students. We used an adopted classification of linking words, categorized in 5 groups: dynamic, static, illustrative, definition and clinical case information. At the end of the semester the concept maps related to the respiratory (mid-semester) and endocrine systems (end of semester) were analyzed and compared. We found linking words not included in any of the five categories, thus a group named “other” has been created. Statistically significant differences were found in dynamic and “other” categories (p=0,049 and p= 0,011, respectively; Wilcoxon signed-rank test). The dynamic words were the most commonly used, probably reflecting students’ need to better describe pathophysiological mechanisms, and the difference found was probably due an improvement in the learning process and concept maps building technic. It would be interesting next year to conduct a more detailed analysis, increasing the sample and ensuring a more robust dataset. 

scholarly journals Role of JIGSAW method of teaching in improving clinical diagnosis among final year medical students – A prospective observational study

2021 ◽  
Vol 12 (12) ◽  
pp. 44-49
Author(s):  
Appandraj S ◽  
Sivagamasundari V ◽  
Varatharajan Sakthivadivel
Keyword(s):  
Observational Study ◽  
Test Score ◽  
Prospective Observational Study ◽  
Coronary Syndrome ◽  
Post Test ◽  
Jigsaw Method ◽  
The Mean ◽  
The Difference ◽  
Didactic Lecture ◽  
Teaching Learning

Background: The Jigsaw method is a form of cooperative learning, in which students are actively involved in the teaching-learning process that improves the long-term retention of acquired knowledge. Aims and Objectives: The objective of this study was to assess the knowledge acquired by students using the Jigsaw learning method in Internal Medicine. Materials and Methods: A prospective observational study was conducted with 100 students. The acute coronary syndrome was taken for 1 h as a didactic lecture, and a pre-test was conducted. The students were divided into five groups and were put for the intervention “Jigsaw.” The pre- and post-test were conducted, and feedback was collected from the students. Paired t-test was used to perform analysis of pre- and post-test. Feedback evaluation was done by a 5-point Liker scale. P<0.05 was considered statistically significant, and the data were analyzed using CoGuide software. Results: The mean pre-test score was 8.44 ± 2.33 ranged (3–14) and the mean post-test score was 11.03 ± 2.07 (ranged 6–15). The difference of 2.39 (95% CI: 2.19–2.59) increase in marks post-test after the Jigsaw method was statistically significant (P<0.001). The satisfaction level was 50–55% on the Likert scale based on the questionnaire given. There was a significant improvement in the post-test scores of the students after Jigsaw. Conclusion: The Jigsaw method improved knowledge in the short-term by engaging students in group work and motivation to learn. Overall response based on the questionnaire about the Jigsaw method was positive.

scholarly journals COMPARATIVE STUDY OF CLINICAL VERSUS USG IN DIAGNOSIS OF EARLY TRIMESTER BLEEDING PV

2020 ◽  
pp. 60-62
Author(s):  
Narendra Nath Hait ◽  
Brahmarshi Das ◽  
Ratan Chandra Mandal ◽  
Haricharan Roy ◽  
Debarshi Jana
Keyword(s):  
Statistical Analysis ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Common Cause ◽  
Clinical Method ◽  
Medical College ◽  
Threatened Miscarriage ◽  
Obstetrics And Gynaecology ◽  
Threatened Abortion ◽  
The Difference

Background: Threatened abortion is till most common cause of early trimester bleeding PV and can be diagnosed and managed by early USG diagnosis. Materials and methods: This was a prospective observational study. Place of the study was Department of Obstetrics and Gynaecology and Department of Radiodiagnosis, Midnapore Medical College and Hospital from January 2019 to June 2020. Eighteen months. Result: When the clinical method to diagnose threatened miscarriage was compared to the sonographic method, it was evident that sonographic method was reliable than the clinical method and the difference was statistically significant. Conclusion: In case of missed miscarriage and complete miscarriage, although the percentage of discrepancy was 100%, on further statistical analysis, the discrepancy was not statistically significant. And the cause behind this was probably inadequate sampling.

Study on Classification of Information to Realize Grid Intelligent

2012 ◽  
Vol 614-615 ◽  
pp. 1706-1709 ◽  
Author(s):  
Wei Liang Li ◽  
Ji Liu ◽  
Wei Tian
Keyword(s):  
Power Grid ◽  
Visual Display ◽  
International Standards ◽  
Energy Access ◽  
Unified Modeling ◽  
Information Classification ◽  
Model Control ◽  
New Energy ◽  
The Difference ◽  
Automation Control

The accsess of large numbers of new energy and the difference of application requirements make information more huge and complex, different application system and different grid link has also a different protocol standards,All these make the visual display of information, unified modeling for power grid automation become complicated and trival. This article according to analysis the power grid stability and control theory, from the power grid stability and controlling ,the needed information and IEC61968 / IEC61970 / IEC61850 and other international standards are analyzed, and propose a power network information classification method, and get a power information classification, accord with smart grid construction and new energy access requirements. It can effectively direct building of power automation control model, control information interaction. Provide foundation support for grid unified modeling and the method of unified describe model.

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