1,721,005 research outputs found
Rapid Assessment of Avoidable Blindness Dataset: Moldova (2012)
No full textAnonymous participant level dataset including variables for visual acuity, spectacle use, lens status, cause of vision impairment, cataract surgical history, barriers to cataract surgery and population count data for five-year age-gender groups for males and females 50 years and olde
Les fonctions visuelles et initiation aux techniques d'examen en ophtalmologie: recommendation methodique
No full textCurrent concepts in concomitant strabismus management
No full textBackground: Strabismus is the term used to describe a misalignment of the eyes. It results from an abnormality of the neuromuscular control of eye movements. However, our current understanding of this anomaly remains incomplete. Although strabismus is a common ocular disorder, estimates of the prevalence vary widely, and in some regions of Europe prevalence is not known. There are various treatment options such eye patching, eyeglasses, prisms and orthoptic exercises. Surgery is typically recommended in those cases where the misalignment cannot be treated with any of the latter methods. Each of the various treatment options has its own advantages and drawbacks, which should be communicated to the patient. Misconceptions about the surgical procedure and its outcome may explain why some patients delay seeking treatment, although other unknown issues may be involved. Knowing patients’ motivations to seek surgery and reasons for strabismus surgery postponement can facilitate patient engagement in decision making process. Shared decision making (SDM) is the communication process where the health care provider and patient exchange views on benefits, risks, personal preferences, and values. The introduction of SDM is claimed to be a step forward to a more person-centered type of medicine, resulting in higher patient satisfaction. Yet, information about the effect of SDM within the field of strabismus, is limited. A variety of factors must be taken into consideration in the planning of strabismus surgery. Factors less studied are the potential structural changes that occur at the distal end of the extraocular muscles, a region of the muscle known to contain proprioceptors. Disruption of the proprioceptive signal during strabismus surgery may hence be an additional confounding factor. A better understanding of the clinical implications associated with changes in ocular proprioception may help to improve the predictability in strabismus surgery and improve outcome modelling. The aim of this thesis was to expand our understanding of the epidemiological, clinical, and morphological aspects of manifest concomitant strabismus.
Main results: Results from these studies revealed a prevalence proportion of pediatric manifest strabismus in the Republic of Moldova of 1.3%. The highest rate of newly detected type of manifest strabismus was esotropia, meanwhile the exotropia comes second, with 16.7 eso cases/10000 children years versus 4.9 exo cases/10000 children years (Paper 2). Similar results showed the following hospital-based clinical study (Chapter 5.2) performed among surgically treated children for manifest concomitant strabismus, acquired esotropia being the most frequent type of strabismus (70.4%). Meanwhile, in adult inpatients, the most common type of surgically treated manifest concomitant strabismus was intermittent exotropia (45.7%), followed by aquired esotropia (39.5%). Amblyopia was diagnosed in 47.7% of cases with a nearly similar frequency among children and adults 45.9% and 50.6% respectively. Strabismus surgery had been delayed for about 20 years in adult patients who could potentially have benefitted from it in childhood. The most common reason for delay in surgical treatment for strabismus reported by patients was lack of awareness about surgery 37.4%. The primary motivation for seeking surgical treatment for strabismus in adulthood was to enhance appearance 38.5% (Papers 4). We have identified concerns among patients about the Shared Decision Making process related to the enough information delivery to take a decision about patient preferences. Furthermore, it was established that the higher the SDM score, which means higher patient involvement in their healthcare process, the higher is their satisfaction with the provided care. In our research the interrelation between SDM process (SDM-Q-9 score) and the patient satisfaction with surgery outcome, adjusted for age (r = 0.834, p < 0.01) has been established (Paper 5). Histological analysis of the distal tendon, obtained from extraocular muscles during strabismus surgery, revealed that foreshortening of the myotendinous region by a critical length affects the proprioceptors that reside in this area of the muscles. The postoperative residual angle of deviation gradually decreased over time in those patients where the receptors had been retained, in contrast to the cases where the receptors had been disrupted (Paper 3).
Conclusions: The lower prevalence of pediatric manifest strabismus (1.3%), with esotropia being the most frequently detected type (16.7 eso cases/10000 children), found in the Republic of Moldova compared with other European countries is thought to be caused by lacking of an effective and efficient screening systems. Although there appears to be a relatively low prevalence of pediatric manifest strabismus in the Republic of Moldova, there is a dearth of well-designed population based studies on strabismus, resulting in the lack of epidemiological information on strabismus within the general Moldavian population . Furthermore, results from the current study support the theory that avoiding disruption of receptors during strabismus surgery results in a better postoperative result. The findings of this study can serve as a springboard to further improving communication and SDM between patients and physicians, thereby raising patient satisfaction in strabismus care. The study underlines the importance of further analysis and validation of on-ground interactions among adolescents, adults, and clinicians across the strabismus management trajectory.publishedVersio
Strabismul adultului: beneficiile tratamentului chirurgical
Get PDFStudiul a inclus 43 de pacienţi strabici. 27 de pacienţi
au prezentat esodeviaţii, iar 16 – exodeviaţii. Intervenţiile
chirurgicale au constat în recesie musculară (43,33%
esotropii şi 11,77% exotropii), rezecţie musculară (6,67%
esotropii şi 29,41% exotropii), recesie-rezecţie (50,00%
esotropii şi 58,82% exotropii). Postoperatoriu deviaţia strabică
s-a redus la nivel de ortotropie (6-8 DP) în 77,77%
din cazuri pentru esotropii şi 81,25% cazuri pentru exotropii,
iar în câteva cazuri (16,26% ) s-a înregistrat succes din
punct de vedere al binocularităţii
Corneal cecity
Get PDFCatedra Oftalmologie, USMF «Nicolae Testemiţanu»The cornea is a perfectly transparent membrane that is a part of optic system of the eye and plays a main role in the visual process. According to the WHO statistic the corneal cecity represent 7% of all causes of cecity. Causes can be: genetic errors, injury, conjunctivitis, avitaminosis A, xerosis of the eye, et al. The only method of treatment of corneal scar is keratoplasty which has same very particularly requests but depend on the material and financial condition in developing countries.
Corneea este o membrană perfect transparentă, care face parte din sistemul optic al globului ocular şi joacă un rol esenţial în procesul vederii. Conform statisticii OMS cecitatea de origine corneană ocupă un loc deloc neglijabil: 7% din ansamblul cauzelor cecităţii. Cauzele pot fi multiple: erorile genetice, traumatismele, conjunctivitele, avitaminoza A, xeroza oculară etc. Singura metodă de tratament a cicatricilor corneene este keratoplastia, care la rîndul ei presupune reuniunea cîtorva condiţii foarte particulare dar, care rămîn în mare parte dependente de condiţiile materiale şi financiare în tările în curs de dezvoltare
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Suspecție carcinom scuamos conjuctival. Caz clinic
Get PDFIntroducere: Carcinomul scuamos conjunctival este o formă de cancer a suprafeței ochiului,
care apare ca o leziune albicioasă sau galben-rozalie. Este cel mai frecvent cancer al
conjunctivei și este cauzat de o creștere anormală a celulelor epiteliale scuamoase, asociată
cu factori precum expunerea excesivă la soare (radiații UV) și infecția cu papilomavirus
uman (HPV).
Scopul lucrării: Prezentarea unui caz clinic al unui pacient cu suspecție la carcinom
scuamos conjuctival, cu prezentarea diagnosticului diferențial și evidențierea importanței
biopsiei pentru stabilirea diagnosticului final.
Materiale și metode: Anamneza, datele clinice și paraclinice au fost colectate din fișa de
observație clinică. Explorările au inclus: examinarea oftalmologică completă și biopsia
conjuctivei.
Rezultate: Pacientul X s-a prezentat de urgență la SCR, Secția Oftalmologie cu următoarele
acuze: durere și discomfort la OS. Din spusele pacientului de aproximativ 2 ani a observat
apariția unei formațiuni la nivelul conjuctivei la OS, iar acuzele sus-numite au aparut în urmă
cu aproximativ 6 luni. A fost recomandată efectuarea biopsiei conjuctivei pentru stabilirea
diagnosticului.
Concluzie: Suspiciunea de carcinom scuamos conjunctival necesită o evaluare atentă și un
diagnostic diferențial riguros. Biopsia este esențială pentru confirmarea diagnosticului și
orientarea tratamentului corect, asigurând un prognostic favorabil și conservarea funcției
oculare
Teprotumumab - the new biological target in the management of thyroid orbitopathy
No full textIntroducere. Orbitopatia tiroidiană (OT) reprezintă o condiţie autoimună complexă, cu o clinică oculară variată ca diplopia, diminuarea vederii şi alterări progresive ale aspectului facial. Tratamentele tradiţionale arată eficienţă restrânsă privind componentele structurale ale bolii cum ar fi proptozisul şi diplopia. Scop. Expunerea metodelor de tratament inovatoare în OT focalizate în special pe tratamentul biologic ţintit reprezentat de Teprotumumab - anticorp monoclonal îndreptat împotriva receptorului pentru IGF-1R. Material şi metode. Review-ul datelor actuale analizând publicaţii şi articole ştiinţifice PubMed, Science-Direct şi Elsevier, publicate în perioada 2016-2022 referitor la mecanismul patogenetic al OT, cu sublinierea rezultatelor obţinute în vederea eficacităţii teprotumumabului - anticorpul îndreptat împotriva receptorului pentru factorul de creştere tip insulinic 1. Rezultate. Prin blocarea traseului IGF-1R/TSHR teprotumumabul diminuează eliberarea de citokine proinflamatorii. Aceasta cauzează stimularea de fibroblaste orbitare şi depunerea de hialuronan - contribuind astfel la expansiunea ţesutului adipos şi a muşchiului extraocular, dezvoltarea edemului şi a inflamaţiei. Prin urmare, acest anticorp monoclonal poate diminua semnalizările iniţiate la oricare dintre receptori, blocând orice răspuns patologic imun în Orbitopatia Tiroidiană. Eficienţa sa în reducerea proptozisului, ameliorarea diplopiei şi scăderii activităţii bolii a dus la aprobarea sa drept prim tratament biologic direcţionat pentru OT. Concluzii. Studiile clinice recente cu referire la patogeneza orbitopatiei tiroidiene indica o tranziţie avansată de la terapiile antiinflamatorii nespecifice către abordări biologice individualizate. Prin urmare, teprotumumabul marchează un progres semnificativ în această direcţie.Introduction. Thyroid orbitopathy (OT) represents a complex autoimmune condition with a varied ocular clinic such as diplopia, diminished vision and progressive alterations in facial appearance. Traditional treatments show limited efficacy regarding the structural components of the disease such as proptosis and diplopia. Objective. Highlighting innovative treatment methods in OT particularly focusing on targeted biological treatment represented by Teprotu-mumab- a monoclonal antibody directed against the IGF-1R receptor. Material and methods. Review of current data analyzing PubMed, ScienceDirect and Elsevier scientific publications and articles, published between 2016-2022 regarding the pathogenetic mechanism of OT, underlining the results obtained regarding the efficacy of teprotumumab -the antibody directed against the insulin-like growth factor receptor 1. Results. By blocking the IGF-1R/TSHR pathway, teprotumumab reduces the release of proinflammatory cytokines. This causes the stimulation of orbital fibroblasts and the deposition of hyaluronan - thus contributing to the expansion of adipose tissue and extraocular muscle, the development of edema and inflammation. Therefore, this monoclonal antibody can reduce the signaling initiated at either receptor, blocking any pathological immune response in Thyroid Orbitopathy. Its efficacy in reducing proptosis, improving diplopia and decreasing disease activity has led to its approval as the first targeted biologic treatment for OT. Conclusion. Recent clinical studies with reference to the pathogenesis of thyroid orbitopathy indicate an advanced transition from nonspecific anti-inflammatory therapies to individualized biological approaches. Therefore, teprotu-mumab marks a significant advance in this direction
Variations on the Author
Get PDF“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
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