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At least 829 records · Page 46Linked to original sources
PubMed2001

Should asymptomatic atrophic retinal holes be treated prophylactically in pseudophakic eyes after Nd:YAG laser posterior capsulotomy?

BACKGROUND: Retinal detachment (RD) following cataract extraction is a serious and potentially sight-threatening event that will often necessitate further surgical intervention. Of the several risk factors reported in the literature, Neodymium:YAG laser posterior capsulotomy has been reported to increase the risk of RD following cataract surgery up to 4.9-fold. The purpose of this study is to investigate the difference of characteristics in pseudophakic RD with or without Nd:YAG laser posterior capsulotomy and the possible role of atrophic retinal holes in pseudophakic RD after posterior capsulotomy. METHODS: Retrospective review of 78 cases of pseudophakic RD after uncomplicated extracapsular lens extraction and intraocular lens implantation was done. Twenty-one of them received Nd:YAG laser posterior capsulotomy before RD. We measured the numbers, types, and locations of retinal breaks and several other risk factors associated with RD. Analysis was performed with the system of Statistical Products and Services Solutions (SPSS). RESULTS: The ratio of retinal holes only in retinal breaks that caused retinal detachment was significantly higher in the capsulotomy group than the non-capsulotomy group (12/21 vs 14/57, p = 0.05). Only three patients in the capsulotomy group claimed significant symptoms before the detachment. There was no significant difference in mean number of retinal breaks and break location. Other risk factors predisposing to RD did not differ significantly between the two groups (13/21 vs 23/57, p = 0.12), nor did the interval from cataract surgery to RD (31.20 vs 29.44 months, p = 0.48). CONCLUSIONS: This primitive study suggests that asymptomatic atrophic retinal holes, usually not regarded as an absolute risk factor for RD, might lead to RD preferentially after Nd:YAG laser posterior capsulotomy. Early identification and treatment of such breaks might decrease the incidence of pseudophakic RD. We suggest that it is necessary to perform detailed preoperative and postoperative fundus examination and treat prophylactically any identified breaks, including asymptomatic atrophic retinal holes, in pseudophakic eyes after Nd:YAG laser posterior capsulotomy.

Adult↗
PubMed2003

Prognostic factors for Vogt-Koyanagi-Harada disease.

BACKGROUND: Vogt-Koyanagi-Harada disease is a chronic bilateral granulomatous panuveitis with involvement of the central nervous system, auditory and integumentary systems. The prognosis depends mostly on the development of complications or not. The purpose of this study was to identify the prognostic factors of Vogt-Koyanagi-Harada (VKH) disease. METHODS: Retrospective chart review of all the patients diagnosed with VKH disease between 1991 and 2000 was performed. Data recorded included age, sex, clinical features, systemic manifestations, recurrence, HLA typing, treatment, complications, and final visual acuity. Statistical analysis was performed using Statistical Products and Services Solutions. RESULTS: There were thirty-nine patients, the mean age at presentation was 39.82 +/- 12.38 years. The majority (46.2%) of patients were probable VKH disease, followed by incomplete type (43.5%), with only 10.3% complete type. Ten patients had at least one complication, including cataract in 19 eyes, glaucoma in 4 eyes and choroidal neovascularization in 3 eyes. Fifty eyes (64.1%) had final visual acuity of 6/12 or better. The interval between ocular symptom and treatment had significant effect on the development of complicaion (p = 0.022) and recurrence (p = 0.003), which were also significantly associated with the final visual acuity (p = 0.007). For patients who were diagnosed and treated within two weeks, the extent of exudative retinal detachment correlated significantly with final visual acuity (p = 0.001). CONCLUSIONS: The visual prognosis of VKH disease is generally favorable. The development of complications or recurrence was significantly associated with the visual outcome. Interval between development of ocular symptom and treatment seemed to be an important predictor in the early stage of VKH. It is important to start the treatment early even when the typical features of VKH disease have not completely appeared.

Adolescent↗
PubMed2003

Budesonide/formoterol in a single inhaler (Symbicort) reduces healthcare costs compared with separate inhalers in the treatment of asthma over 12 months.

This open, multinational, randomised, parallel-group, six-month extension conducted in the Swedish centres of a previous six-month study compared the costs of a total of 12 months of treatment with budesonide/formoterol in a single inhaler with budesonide plus formoterol separate inhalers in 320 adults with asthma. Patients received budesonide/formoterol (Symbicort Turbuhaler) 160/4.5 mg delivered doses, two inhalations b.i.d., or corresponding doses of budesonide (Pulmicort Turbuhaler) plus formoterol (Oxis Turbuhaler). Direct costs and indirect costs were estimated. Budesonide/formoterol treatment was associated with reduced healthcare service utilisation and statistically significant reductions in direct (SEK1595, p=0.0004) and total costs (SEK1884, p=0.043) per person per year compared with budesonide plus formoterol. Budesonide/formoterol reduced the average annual emergency room admission cost per person by SEK489.7 (31% of direct cost reduction) and physician costs by SEK235.4 (15%).The direct cost of study, relief and other medication was reduced by SEK893.8 (47% of total reduction). There were no statistically significant differences in efficacy and safety parameters following treatment with budesonide/formoterol from single or separate inhalers, other than a significantly lower proportion of withdrawals with the single inhaler (9.2% vs 19.4%, p=0.008). In summary, budesonide/formoterol treatment from a single inhaler reduced 12-month treatment costs compared with separate inhalers, while maintaining at least as good control of asthma.

Administration, Inhalation↗
PubMed2004

Sexual dimorphism of the calcaneus of South African blacks.

Forensic anthropology is a rapidly growing field in South Africa and skeletal biologists are often called upon by the police to assist in personal identification from skeletal remains, which are recovered in suspected cases of homicide and suicide and in mass disaster. Measurements of the calcaneus have been shown to be sexually dimorphic in South African whites. Since the validity of discriminant function equations in sex determination is population specific, the aim of the present study was to derive similar equations for the calcanei of the South African blacks. The bones that were used in this study were obtained from the Raymond A. Dart Collection of Human Skeletons, School of Anatomical Sciences, University of the Witwatersrand, Johannesburg. One hundred and sixteen (116) intact and non-pathological calcanei, consisting of 58 males and 58 females and belonging to individuals whose age at death ranged between 22 and 75 years, were selected by the simple random sampling technique. The measured variables included the maximum length, the load arm length, the dorsal articular facet length, the body height, the maximum height, the cuboidal facet height, the middle breadth, the dorsal articular facet breadth and the maximum breadth. Discriminant function analyses were done using the Statistical Product and Service Solutions (SPSS) program. All measured parameters of the calcaneus showed significant sexual differences. Length measurements were found to be the most sexually dimorphic. Combinations of variables provided better estimate of sex (79%-86%) than individual variables (64%-79%).

Adult↗
PubMed2005

Discriminating sex in South African blacks using patella dimensions.

For many years, sex determination has been carried out on skeletal remains to identify individuals in forensic cases and to assess populations in archaeological cases. Since it has been shown that not all bones are found in a forensic case, discriminant function equations should be derived for all bones of the body to assist in sex determination. Numerous studies have shown the usefulness of bones of the lower extremity (e.g. femur, tibia) in sex determination using discriminant function analysis, but the use of patella measurements has not been extensively investigated for this purpose. It is therefore the aim of this study to derive discriminant function equations for sex determination from measurements of the patella of South African blacks as represented in the Raymond A. Dart Collection of Human Skeletons. A total sample of 120 (60 male, 60 female) patellae were measured using six measurements. The Statistical Product and Service Solutions (SPSS) program was used to derive the equations. Stepwise and direct analyses were performed with the highest rate of classification of 85% thereby making the patella useful for sex determination. Thus, the proposed equations derived from this study should be used with caution and only on the South African black population group.

Black People↗
PubMed1991

Trichinosis surveillance, United States, 1987-1990.

Since the Public Health Service began recording statistics on trichinosis in 1947, the number of cases reported by state health departments each year has declined. In the late 1940s, health departments reported an average of 400 cases and 10-15 deaths each year; from 1982 through 1986, the number declined to an average of 57 cases per year and a total of three deaths for the period. From 1987 through 1990, 206 cases of trichinosis from 22 states, including 14 multiple-case outbreaks, were reported to CDC. In 1990, two large outbreaks associated with commercial pork accounted for 106 cases. In the 192 instances in which a suspect food item was identified, pork was implicated in 144 (75%) cases, walrus meat in 34 (18%), and bear meat in 14 (7%). Sausage, the most frequently implicated pork product, was associated with 128 of the 139 cases for which a form of ingested pork was specified. Before 1990, the proportion of cases of trichinosis attributable to consumption of commercial pork had declined steadily. This decline was probably due to a combination of factors, including laws prohibiting the feeding of garbage to hogs, the increased use of home freezers, and the practice of thoroughly cooking pork. Although the incidence of trichinosis has decreased substantially since national reporting was initiated in 1947, a dramatic increase in 1990, resulting from two large outbreaks, emphasizes the need for further education and control measures.

Adolescent↗
PubMed1989

A framework for effective quality assurance.

Facilities that have an established QA process but no framework for it run the risk of incomplete, inconsistent monitoring and reporting plus delays in identifying problems and taking action. Facilities with a model that does not promote comprehensive monitoring run the risk of missing problems altogether and providing insufficient data upon which to assess quality. A comprehensive, logical framework will help health care facilities move toward measuring the outcomes of care and service and reporting statistical information that can be reviewed by all consumers. Assessment of quality will be more objective and consistent throughout the organization, and will ensure that changes are made to improve care.

Canada↗
PubMed1981

The Child Referral Centre in Pretoria.

Two main reasons gave rise to the establishment of the Child Referral Centre (CRC) in Pretoria: (i) the particular post-genetic counselling needs of individuals and families suffering from inherited and congenital disorders; and (ii) the general need of parents to know what facility is available for dealing with a suspected disorder or known handicap of their child - usually at the preschool stage. The CRC has been in operation since 1978 and statistics of the service rendered are provided. A feature of the CRC is the administrative procedure which ensures that referral is successful and effective.

Child↗
PubMed1995

The population survey as a tool for assessing family health in the Keewatin region, NWT, Canada.

The population survey is an important tool in community health assessment, including the physical and psychological aspects of family health. It provides data on health status and health determinants not available from vital statistics and health service utilization. The Keewatin Health Assessment Study (KHAS), which was designed in collaboration with the Keewatin Regional Health Board (KRHB), surveyed a representative sample of the predominantly Inuit population in 8 communities in the central Canadian Arctic. The entire survey included 874 individuals in all age groups, of whom 440 were children and adolescents under 18 years of age, and consisted of questionnaires, clinical examination and laboratory tests. Of the large number of variables on which data were collected, some were of particular relevance to the health of children and the well-being of the family, including: (1) Child growth and development; (2) Nutrition and diet; (3) Social pathologies: suicide attempts and sexual abuse; (4) Oral health; and (5) Audiologic health. In addition to providing cross-sectional data, survey participants constitute a cohort which, if followed up longitudinally, can be used to determine the incidence of specific conditions and identify risk factors which promote or prevent their occurrence. An example of such a cohort study is one on acute respiratory infection. Surveys serve many functions--providing data for planning and evaluation, promoting community awareness of health issues, and addressing basic research questions. The KHAS is one of several surveys launched over the past several years which jointly will begin to provide a circumpolar perspective on the health of Inuit people.

Adolescent↗
PubMed1997

Interobserver agreement in the evaluation of acute retinal artery occlusion.

OBJECTIVE: To determine the agreement between two ophthalmologists in the evaluation of two important funduscopic features related to acute retinal artery occlusion: retinal cloudy swelling and visible retinal emboli. DESIGN: An interobserver variability study in which two ophthalmologists (one trained in glaucoma, the other in neuro-ophthalmology) independently viewed fundus photographs and categorized them with respect to the presence or absence of cloudy swelling and retinal emboli. Inter- and intraobserver agreement was calculated with the kappa statistic. SETTING: Retina service at a university-affiliated hospital in Kingston, Ont. PATIENTS: The fundus photographs of 102 patients were included: 60 with acute retinal artery occlusion, 30 with conditions mimicking acute retinal artery occlusion and 12 healthy patients. RESULTS: Both interobserver and intraobserver agreement as to the presence of retinal cloudy swelling were very high (kappa = 0.835 and 0.866 respectively). More variability was seen for the presence of retinal emboli, but, overall, interobserver and intraobserver agreement were still high (kappa = 0.726 and 0.629 respectively). CONCLUSIONS: Our results suggest that clinicians use similar visual clues to categorize fundi with respect to retinal cloudy swelling and visible retinal emboli.

Acute Disease↗