Fundus Examination in Pediatric Patients Using Indirect Ophthalmoscopy

2022 ◽  
pp. 281-305
Author(s):  
Danielle M. Ledoux ◽  
Brandon Johnson ◽  
Issac Moradi ◽  
Lily Zhu-Tam
Keyword(s):  
At Risk ◽  
Premature Infant ◽  
Retinopathy Of Prematurity ◽  
Fundus Examination ◽  
Eye Care ◽  
Indirect Ophthalmoscopy ◽  
Challenging Technique ◽  
Standard Classification ◽  
Rate Limiting

The goal of this chapter is to provide the clinician with an understanding of binocular indirect ophthalmoscopy (BIO) and helpful clinical techniques for success in examining the fundus of the pediatric patient, including scleral depression. The challenging technique to examine the premature infant at risk for retinopathy of prematurity will be explained in detail, including the standard classification of the disease with photos depicting the different location and stages of disease. BIO with the addition of scleral indentation helps the clinician diagnose and locate lesions that may otherwise go undetected, such as retinal holes, tears, or vitreoretinal adhesions. Complete examination of the fundus of a child is no less important than of any other patient who seeks eye care but often requires efficiency and precision (as well as many human arms). Time is a rate limiting aspect when examining children so preparation and experience will lead to success.

Retinopathy of Prematurity in the 1990s

1999 ◽  
Vol 18 (2) ◽  
pp. 31-38 ◽  
Author(s):  
Sharon Lee
Keyword(s):  
Risk Factors ◽  
At Risk ◽  
Retinopathy Of Prematurity ◽  
Current Knowledge ◽  
Visual Impairments ◽  
International Classification

Infants diagnosed with retinopathy of prematurity (ROP) are at risk for developing visual impairments. The International Classification of ROP (ICROP) developed the most useful tool available for communicating the location and extent of the condition, with three zones to describe the location and five stages to describe the extent.Despite current knowledge and treatment, however, 500 infants are blinded each year by ROP. Infants at highest risk are the smallest and most immature. The nurse must understand why and how ROP occurs and the forms of management used to treat ROP. This article reports on the incidence, pathophysiology, risk factors, screening, treatment, and long-term complications of ROP in the 1990s.

scholarly journals Validity of classification of distal radial fractures in the Swedish fracture register

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Malena Bergvall ◽  
Carl Bergdahl ◽  
Carl Ekholm ◽  
David Wennergren
Keyword(s):  
Gold Standard ◽  
Reference Group ◽  
Observer Agreement ◽  
Distal Radial Fractures ◽  
Young Males ◽  
Small Peak ◽  
National Quality ◽  
Fracture Register ◽  
Standard Classification

Abstract Background Distal radial fractures (DRF) are one of the most common fractures with a small peak in incidence among young males and an increasing incidence with age among women. The reliable classification of fractures is important, as classification provides a framework for communicating effectively on clinical cases. Fracture classification is also a prerequisite for data collection in national quality registers and for clinical research. Since its inception in 2011, the Swedish Fracture Register (SFR) has collected data on more than 490,000 fractures. The attending physician classifies the fracture according to the AO/OTA classification upon registration in the SFR. Previous studies regarding the classification of distal radial fractures (DRF) have shown difficulties in inter- and intra-observer agreement. This study aims to assess the accuracy of the registration of DRF in adults in the SFR as it is carried out in clinical practice. Methods A reference group of three experienced orthopaedic trauma surgeons classified 128 DRFs, randomly retrieved from the SFR, at two classification sessions 6 weeks apart. The classification the reference group agreed on was regarded as the gold standard classification for each fracture. The accuracy of the classification in the SFR was defined as the agreement between the gold standard classification and the classification in the SFR. Inter- and intra-observer agreement was evaluated and the degree of agreement was calculated as Cohen’s kappa. Results The accuracy of the classification of DRF in the SFR was kappa = 0.41 (0.31–0.51) for the AO/OTA subgroup/group and kappa = 0.48 (0.36–0.61) for the AO/OTA type. This corresponds to moderate agreement. Inter-observer agreement ranged from kappa 0.22–0.48 for the AO/OTA subgroup/group and kappa 0.48–0.76 for the AO/OTA type. Intra-observer agreement ranged from kappa 0.52–0.70 for the AO/OTA subgroup/group and kappa 0.71–0.76 for the AO/OTA type. Conclusions The study shows moderate accuracy in the classification of DRF in the SFR. Although the degree of accuracy for DRF appears to be lower than for other fracture locations, the accuracy shown in the current study is similar to that in previous studies of DRF.

Classifying Predicates and Languages

1997 ◽  
Vol 08 (01) ◽  
pp. 15-41 ◽  
Author(s):  
Carl H. Smith ◽  
Rolf Wiehagen ◽  
Thomas Zeugmann
Keyword(s):  
Learning Theory ◽  
Classification Problems ◽  
Attention In Learning ◽  
Recursive Functions ◽  
Standard Classification ◽  
Resource Bound ◽  
Multi Classification

The present paper studies a particular collection of classification problems, i.e., the classification of recursive predicates and languages, for arriving at a deeper understanding of what classification really is. In particular, the classification of predicates and languages is compared with the classification of arbitrary recursive functions and with their learnability. The investigation undertaken is refined by introducing classification within a resource bound resulting in a new hierarchy. Furthermore, a formalization of multi-classification is presented and completely characterized in terms of standard classification. Additionally, consistent classification is introduced and compared with both resource bounded classification and standard classification. Finally, the classification of families of languages that have attracted attention in learning theory is studied, too.

scholarly journals Fungal diseases of tree stands under urbanized conditions of Moscow

2013 ◽  
pp. 241-247
Author(s):  
Oksana Smirnova ◽  
Aleksej Smirnov
Keyword(s):  
At Risk ◽  
Support System ◽  
Dynamic Equilibrium ◽  
Fungal Diseases ◽  
Ecological Situation ◽  
Fomitopsis Pinicola ◽  
Phellinus Igniarius ◽  
Fomes Fomentarius ◽  
Experimental Station

Phytosanitary and ecological estimation of tree-stands has been con?ducted at the Forest Experimental Station of Moscow Agricultural Academy and parks of Northeast of Moscow in 2007-2011. Fomes fomentarius was proved to be a very serious pathogen of trees under conditions of Moscow, Piptoporus betulinus, Phellinus igniarius, and Fomitopsis pinicola also occurred and caused damage to trees. This rather bad phytosanitary situation depends on alarming ecological situation in Moscow. At the Forest Experimental Station of Moscow Agricultural Academy a number and cover of lichens decreased. In general, all trees in Moscow are in dynamic equilibrium with the urbanized environment. In connection with this, the following classification of tree-stands was proposed for the urbanized environment: 1 - healthy trees, 2 - affected trees which can be managed, 3 - dry woods, 3a - very diseased. Many tree-stands in investigated regions of Moscow are found to belong to the groups 2 and 3c. All tree-stands must be carefully monitored and managed in order to provide a well-timed decision on the support system for preservation of trees as ?lungs of city? and avoid unpredictable tree falling which put people and traffic at risk.

scholarly journals Socio-economic impact in the late diagnosis of retinopathy of prematurity

2016 ◽  
Vol 11 (1) ◽  
pp. 45-48
Author(s):  
Daniela POPESCU ◽  
◽  
Dumitru MATEI ◽  
◽  
◽  
...  
Keyword(s):  
Risk Factor ◽  
Human Resources ◽  
Retinopathy Of Prematurity ◽  
Social Impact ◽  
Treatment Programs ◽  
Additional Risk Factor ◽  
Fundus Examination ◽  
Additional Risk ◽  
Simple Process ◽  
Socio Economic Impact

Retinopathy of prematurity (ROP) represents a determinate cause of blindness in children that could be avoided. Blindness due to ROP and the stage of it when its being diagnosed is mostly determined by: socioeconomic degree of country development; availability of the screening in neonatal care; gestational age and hospital screenings; treatment programs available at any given time in the country; screening and treatment costs (material and human resources). ROP is the number one cause of blindness in Romania at the time being. Early discovery decreases exponentially the chances of blindness onset. Low birth weight (LBW), fewer than 1,500 g, represents an additional risk factor together with the degree of prematurity. Mandatory screening both during hospitalization as well as in the first 4-6 weeks after birth may avoid a major social problem. It is a simple process – eye exam with fundus examination – and it depends entirely on the availability, consistency and seriouseness of the parents. Thus a major social impact with disastrous consequences could be avoided.

scholarly journals Taxonomic patterns in the zoonotic potential of mammalian viruses

PeerJ ◽  
2018 ◽  
Vol 6 ◽  
pp. e5979 ◽  
Author(s):  
Alex D. Washburne ◽  
Daniel E. Crowley ◽  
Daniel J. Becker ◽  
Kevin J. Olival ◽  
Matthew Taylor ◽  
...  
Keyword(s):  
Infectious Disease ◽  
At Risk ◽  
Life Histories ◽  
Coarse Graining ◽  
International Committee ◽  
Zoonotic Potential ◽  
Human Host ◽  
Disease Biology ◽  
Taxonomic Patterns

Predicting and simplifying which pathogens may spill over from animals to humans is a major priority in infectious disease biology. Many efforts to determine which viruses are at risk of spillover use a subset of viral traits to find trait-based associations with spillover. We adapt a new method—phylofactorization—to identify not traits but lineages of viruses at risk of spilling over. Phylofactorization is used to partition the International Committee on Taxonomy of Viruses viral taxonomy based on non-human host range of viruses and whether there exists evidence the viruses have infected humans. We identify clades on a range of taxonomic levels with high or low propensities to spillover, thereby simplifying the classification of zoonotic potential of mammalian viruses. Phylofactorization by whether a virus is zoonotic yields many disjoint clades of viruses containing few to no representatives that have spilled over to humans. Phylofactorization by non-human host breadth yields several clades with significantly higher host breadth. We connect the phylogenetic factors above with life-histories of clades, revisit trait-based analyses, and illustrate how cladistic coarse-graining of zoonotic potential can refine trait-based analyses by illuminating clade-specific determinants of spillover risk.

Self-Concept Correlates between At-Risk and Not-At-Risk Ninth-Grade Students

1995 ◽  
Vol 76 (2) ◽  
pp. 683-687 ◽  
Author(s):  
Mary H. Jackson ◽  
Kimberly B. Reddick ◽  
Richard G. Dubes
Keyword(s):  
At Risk ◽  
Ninth Grade ◽  
Self Concept ◽  
Dropping Out ◽  
Satisfaction Scale ◽  
Ninth Grade Students ◽  
Not At Risk ◽  
Multivariate Discriminant ◽  
Item Scale

This study examined whether the Tennessee Self-concept Scales could be used to discriminate among 43 ninth-grade students who were designated as being at risk of dropping out of high school and 47 students who were thought to show probability of persisting. Scores on the scales were submitted to stepwise multivariate discriminant analysis. Scores on the Self-satisfaction Scale constituted a linear function that correctly classified 72.22% of the subjects. Further investigation confirmed a 13-item scale selected from the Tennessee Self-concept Scales correctly identified the classification of 76.67% of the students.

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