The ability to predict presenteeism and absenteeism in nursing is useful to constrain costs and ensure that quality care is delivered.
Glaucoma services are overwhelmed and struggling to accommodate current demand. Reducing the need for hospital based services would improve our ability to see those most at risk of vision loss, which could both reduce demand and improve patient outcomes. Digital technologies that provide opportunities for home monitoring of glaucoma progression have potential to contribute to solve these challenges and, potentially, improve glaucoma care. This article will review the literatures of well-established technologies that support home monitoring for glaucoma, specifically home tonometry (with rebound tonometry) and perimetry with Moorfields Motion Displacement Test and Melbourne Rapid Field.
AimTo evaluate the existing evidence on relative efficacy and tolerability of topical mono-compound intraocular pressure (IOP)-lowering drugs in treatment of primary open angle glaucoma (POAG) and ocular hypertension (OHT).MethodsIn this systematic review of systematic reviews/meta-analyses of randomized controlled trials a thorough and sensitive search of PubMed, Embase and Cochrane Databases was performed. Individual study methodological quality and quality of evidence were assessed using the AMSTAR checklist and the GRADE system, respectively. The relationships between individual drugs were evaluated based on the best available evidence.ResultsOf the 133 initial non-duplicate records, 16 studies met the inclusion criteria. Five achieved an overall “moderate” (none achieved “high”) quality of evidence and evaluated prostaglandin analogues (PGAs) – latanoprost, travoprost, and bimatoprost; timolol; “other beta-blockers;” carbonic anhydrase inhibitors (CAI) as a group or dorzolamide separately; and brimonidine. “Moderate quality” refers to efficacy and incidence of conjunctival hyperemia. Quality of evidence regarding other tolerability aspects was low. PGAs should be considered equivalent regarding efficacy, but latanoprost was relevantly better tolerated than the other two. Non-PGA compounds did not relevantly differ between each other in either efficacy or safety. Timolol and brimonidine were relevantly less effective than all PGAs. The same was true for CAI vs bimatoprost. Regarding tolerability, timolol was superior to all PGAs and brimonidine and CAI were superior to bimatoprost.ConclusionNo high quality evidence on relative efficacy and tolerability of the most commonly used mono-compound IOP-lowering drugs for POAG/OHT exists. Moderate quality evidence indicates latanoprost as a treatment with the most favorable trade-off between benefits and harms.
INTRODUCTION:Cutaneous larva migrans (CLM) is a dermatitis caused by hookworm larvae inoculation in the skin, most commonly acquired among individuals in tropical and sub-tropical areas or travelers who have visited those areas. The typical clinical presentation consists of itchy serpiginous lesion that advances.CASE REPORT:We are reporting a long time misdiagnosed case of a 37-year-old farmer from continental European region with a typical clinical presentation, and no history of traveling to endemic areas. We made the diagnosis of the CLM based on the patient’s history of itchy skin that had advanced for a few months, and clinical characteristics of the lesion in the right gluteus region consisting of erythema, papula and vesicles, together with erythematous/livid serpiginous tracks that formed an irregular and capricious path. The patient was successfully treated with oral mebendazole twice daily for three days and local therapy.
Hallermann-Streiff syndrome is a rare congenital disorder characterized as a complex association of developmental anomalies involving structures of ectodermal origin (the face, the scull, the hair, the skin, the eyes, the teeth) and overall growth and development. Ophthalmic abnormalities included bilateral congenital cataract. Glaucoma is uncommon. We report a case with Hallermann-Streiffsyndrome having all the main features of the syndrome, however associated with juvenile glaucoma and without congenital cataract. An 16 year-old-boy was admitted in our hospital for surgical treatment of juvenile glaucoma. His ophthalmic features included microphthalmos, enophthalmos, short upper lid, and thin conjunctiva, edematous corneas with fine epithelial bulla, atrophic-colobomatous iris in the left eye, slightly dilated pupils and clear lenses. The right optic disc was pale and cupped (0.9-1). The left optic disc was pale. The IOP was 70 mmHg in the right eye and 62 mmHg in the left eye. There was no light perception on the right eye and 1/60 in the left improving to 0.1 with +7.0 Dsph. Antiglaucomatous therapy failed to reduce the pressure and a left trabeculecthomy was carried out. Protective eye shields during sleep were recommended to protect the corneas from dryness because of the short upper lids. In the left eye the IOP has fallen to within normal limits and the vision has improved 0.3-0.4 with +7.0 Dsph. The medical therapy was continued in the right eye but the pressure still remains high (40 mmHg).
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