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[PMID]:29506509
[Au] Autor:Zhang Z; Zhou M; Liu K; Zhu B; Liu H; Sun X; Xu X
[Ad] Endereço:Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, China.
[Ti] Título:Development of a new valid and reliable microsurgical skill assessment scale for ophthalmology residents.
[So] Source:BMC Ophthalmol;18(1):68, 2018 Mar 05.
[Is] ISSN:1471-2415
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: More and more concerns have been arisen about the ability of new medical graduates to meet the demands of today's practice environment. In this study, we wanted to develop a valid, reliable and standardized assessment tool for evaluating the basic microsurgical skills of residents in a microsurgery laboratory, to get them well prepared before entering the surgical realm of ophthalmology. METHODS: Twenty-three experts who have teaching experience reviewed the assessment scale. Constructive comments were incorporated to ensure face and content validity. Twenty-one attendings from different specialties then graded eight corneal rupture suturing videos with the scale to investigate interrater reliability. Fourteen of them graded the same videos 3 months later to investigate intrarater reliability (repeatability). RESULTS: A total of 280 assessment scales were completed. All the ICC values of interrater reliability were greater than 0.8 with 75% data greater than 0.9 (range 0.860-0.976). All the ICC values of intrarater reliability (repeatability) were also greater than 0.8 with 63% data greater than 0.9 (range 0.833-0.954). CONCLUSIONS: The assessment scale we developed is valid and reliable. This tool could be useful to ensure that junior residents achieve a certain level of microsurgical technique in a laboratory environment before training in the operation room. Hopefully, this tool will provide a structured template for other residency programs to assess their residents for basic microsurgical skills.
[Mh] Termos MeSH primário: Competência Clínica/normas
Avaliação Educacional/métodos
Internato e Residência
Microcirurgia/educação
Procedimentos Cirúrgicos Oftalmológicos/educação
Oftalmologia/educação
Técnicas de Sutura/educação
[Mh] Termos MeSH secundário: Lesões da Córnea/cirurgia
Seres Humanos
Reprodutibilidade dos Testes
Inquéritos e Questionários
[Pt] Tipo de publicação:JOURNAL ARTICLE; VALIDATION STUDIES
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180311
[Lr] Data última revisão:
180311
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180307
[St] Status:MEDLINE
[do] DOI:10.1186/s12886-018-0736-z


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[PMID]:28453427
[Au] Autor:Lamson KS; Hinton EG
[Ad] Endereço:a MCPHS University , Worcester , Massachusetts , USA.
[Ti] Título:VisionCite: A Vision Science-Related Database.
[So] Source:Med Ref Serv Q;36(2):165-170, 2017 Apr-Jun.
[Is] ISSN:1540-9597
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:VisionCite is a database dedicated to the visual sciences. This paid subscription database provides bibliographic information for optometry and ophthalmology-related resources and is maintained by the Illinois College of Optometry (ICO) Library. A sample search is provided, highlighting different features of the newly redesigned database.
[Mh] Termos MeSH primário: Bases de Dados Factuais
Oftalmologia
Optometria
[Mh] Termos MeSH secundário: Seres Humanos
Illinois
Bibliotecas Médicas
Visão Ocular
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:H
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.1080/02763869.2017.1293984


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[PMID]:29391860
[Au] Autor:Galor A; Small L; Feuer W; Levitt RC; Sarantopoulos KD; Yosipovitch G
[Ad] Endereço:Miami Veterans Administration Medical Center, Miami, Florida (Dr Galor); Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami, Miami, Florida (Dr Galor, Dr Small, Mr Feuer); and Department of Anesthesiology, Perioperative Medicine and Pain Management (Dr Levitt, Dr Sarantopo
[Ti] Título:The Relationship Between Ocular Itch, Ocular Pain, and Dry Eye Symptoms (An American Ophthalmological Society Thesis).
[So] Source:Trans Am Ophthalmol Soc;115:T5, 2017 Aug.
[Is] ISSN:1545-6110
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Purpose: To evaluate associations between sensations of ocular itch and dry eye (DE) symptoms, including ocular pain, and DE signs. Methods: A cross-sectional study of 324 patients seen in the Miami Veterans Affairs eye clinic was performed. The evaluation consisted of questionnaires regarding ocular itch, DE symptoms, descriptors of neuropathic-like ocular pain (NOP), and evoked pain sensitivity testing on the forehead and forearm, followed by a comprehensive ocular surface examination including corneal mechanical sensitivity testing. Analyses were performed to examine for differences between those with and without subjective complaints of ocular itch. Results: The mean age was 62 years with 92% being male. Symptoms of DE and NOP were more frequent in patients with moderate-severe ocular itch compared to those with no or mild ocular itch symptoms. With the exception of ocular surface inflammation (abnormal matrix metalloproteinase 9 testing) which was less common in those with moderate-severe ocular itch symptoms, DE signs were not related to ocular itch. Individuals with moderate-severe ocular itch also demonstrated greater sensitivity to evoked pain on the forearm and had higher non-ocular pain, depression, and post-traumatic stress disorders scores, compared to those with no or mild itch symptoms. Conclusions: Subjects with moderate-severe ocular itch symptoms have more severe symptoms of DE, NOP, non-ocular pain and demonstrate abnormal somatosensory testing in the form of increased sensitivity to evoked pain at a site remote from the eye, consistent with generalized hypersensitivity.
[Mh] Termos MeSH primário: Síndromes do Olho Seco/diagnóstico
Oftalmopatias/diagnóstico
Dor Ocular/diagnóstico
Prurido/diagnóstico
[Mh] Termos MeSH secundário: Córnea/fisiologia
Estudos Transversais
Síndromes do Olho Seco/fisiopatologia
Oftalmopatias/fisiopatologia
Dor Ocular/fisiopatologia
Feminino
Seres Humanos
Masculino
Meia-Idade
Oftalmologia/organização & administração
Medição da Dor
Prurido/fisiopatologia
Qualidade de Vida
Fenômenos Fisiológicos da Pele
Sociedades Médicas
Inquéritos e Questionários
Lágrimas/fisiologia
Estados Unidos
Veteranos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180216
[Lr] Data última revisão:
180216
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE


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[PMID]:29365282
[Au] Autor:Desai S; McWilliams JM
[Ad] Endereço:From the Department of Population Health, New York University, New York (S.D.); and the Department of Health Care Policy, Harvard Medical School (S.D., J.M.M.), and the Division of General Internal Medicine and Primary Care, Brigham and Women's Hospital (J.M.M.) - both in Boston.
[Ti] Título:Consequences of the 340B Drug Pricing Program.
[So] Source:N Engl J Med;378(6):539-548, 2018 02 08.
[Is] ISSN:1533-4406
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The 340B Drug Pricing Program entitles qualifying hospitals to discounts on outpatient drugs, increasing the profitability of drug administration. By tying the program eligibility of hospitals to their Disproportionate Share Hospital (DSH) adjustment percentage, which reflects the proportion of hospitalized patients who are low-income, the program is intended to expand resources for underserved populations but provides no direct incentives for hospitals to use financial gains to enhance care for low-income patients. METHODS: We used Medicare claims and a regression-discontinuity design, taking advantage of the threshold for program eligibility among general acute care hospitals (DSH percentage, >11.75%), to isolate the effects of the program on hospital-physician consolidation (i.e., acquisition of physician practices or employment of physicians by hospitals) and on the outpatient administration of parenteral drugs by hospital-owned facilities in three specialties in which parenteral drugs are frequently used. For low-income patients, we also assessed the effects of the program on the provision of care by hospitals and on mortality. RESULTS: Hospital eligibility for the 340B Program was associated with 2.3 more hematologist-oncologists practicing in facilities owned by the hospital, or 230% more hematologist-oncologists than expected in the absence of the program (P=0.02), and with 0.9 (or 900%) more ophthalmologists per hospital (P=0.08) and 0.1 (or 33%) more rheumatologists per hospital (P=0.84). Program eligibility was associated with significantly higher numbers of parenteral drug claims billed by hospitals for Medicare patients in hematology-oncology (90% higher, P=0.001) and ophthalmology (177% higher, P=0.03) but not rheumatology (77% higher, P=0.12). Program eligibility was associated with lower proportions of low-income patients in hematology-oncology and ophthalmology and with no significant differences in hospital provision of safety-net or inpatient care for low-income groups or in mortality among low-income residents of the hospitals' local service areas. CONCLUSIONS: The 340B Program has been associated with hospital-physician consolidation in hematology-oncology and with more hospital-based administration of parenteral drugs in hematology-oncology and ophthalmology. Financial gains for hospitals have not been associated with clear evidence of expanded care or lower mortality among low-income patients. (Funded by the Agency for Healthcare Research and Quality and others.).
[Mh] Termos MeSH primário: Custos de Medicamentos
Economia Hospitalar
Convênios Médico-Hospitalares/estatística & dados numéricos
Medicare Part B/economia
Pobreza
Mecanismo de Reembolso
[Mh] Termos MeSH secundário: Custos e Análise de Custo
Hematologia
Hospitais/estatística & dados numéricos
Seres Humanos
Oncologia
Mortalidade
Oftalmologia
Propriedade
Provedores de Redes de Segurança/economia
Estados Unidos/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180214
[Lr] Data última revisão:
180214
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180125
[St] Status:MEDLINE
[do] DOI:10.1056/NEJMsa1706475


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[PMID]:28455280
[Au] Autor:Dean S; Mathers JM; Calvert M; Kyte DG; Conroy D; Folkard A; Southworth S; Murray PI; Denniston AK
[Ad] Endereço:Health Education England (West Midlands), Birmingham, UK.
[Ti] Título:"The patient is speaking": discovering the patient voice in ophthalmology.
[So] Source:Br J Ophthalmol;101(6):700-708, 2017 06.
[Is] ISSN:1468-2079
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Eye disease can be devastating. The most feared impact is sight loss, but in a number of ophthalmic conditions, there can be wide-ranging systemic, psychological, emotional and social effects of both the disease and its treatment. External tests of visual function, such as visual acuity, are inadequate to understand the overall impact of ophthalmic disease on a patient's functional vision or daily life. This can lead to a discordance between the patient's priorities and perspective on the one hand and the efforts of clinicians and other stakeholders on the other hand. In this review, we discuss how the patient is uniquely placed to understand the impact of the disease and can use that position to transform ophthalmic care at the individual and collective level, from research to care delivery. We highlight how the "patient voice" can contribute to key areas, including priority setting in the research agenda, communicating the wide-ranging impact of disease and its treatment as assessed through qualitative research, identifying the outcome measures that matter to the patient through core outcome set development and reporting these outcomes through appropriate patient-reported outcome measures. We also consider the increasing power of the patient voice on health institutions, ranging from broadcasting an individual's experience of care he/she has received to patient societies influencing future health policy. Finally, we reflect on the challenges that need to be overcome for the patient voice to increasingly influence and improve the delivery of eye care in the future.
[Mh] Termos MeSH primário: Oftalmologia
Avaliação de Resultados da Assistência ao Paciente
Relações Médico-Paciente
Pesquisa Qualitativa
[Mh] Termos MeSH secundário: Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1707
[Cu] Atualização por classe:180203
[Lr] Data última revisão:
180203
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170430
[St] Status:MEDLINE
[do] DOI:10.1136/bjophthalmol-2016-309955


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[PMID]:29256575
[Au] Autor:Food and Drug Administration, HHS.
[Ti] Título:Medical Devices; Ophthalmic Devices; Classification of the Tear Electrostimulation Device. Final order.
[So] Source:Fed Regist;82(241):60114-6, 2017 Dec 19.
[Is] ISSN:0097-6326
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The Food and Drug Administration (FDA or we) is classifying the tear electrostimulation device into class II (special controls). The special controls that apply to the device type are identified in this order and will be part of the codified language for the tear electrostimulation device's classification. We are taking this action because we have determined that classifying the device into class II (special controls) will provide a reasonable assurance of safety and effectiveness of the device. We believe this action will also enhance patients' access to beneficial innovative devices, in part by reducing regulatory burdens.
[Mh] Termos MeSH primário: Terapia por Estimulação Elétrica/classificação
Terapia por Estimulação Elétrica/instrumentação
Segurança de Equipamentos/classificação
Oftalmologia/classificação
Oftalmologia/instrumentação
Lágrimas/secreção
[Mh] Termos MeSH secundário: Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180105
[Lr] Data última revisão:
180105
[Sb] Subgrupo de revista:T
[Da] Data de entrada para processamento:171220
[St] Status:MEDLINE


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[PMID]:27771339
[Au] Autor:Schulz C
[Ad] Endereço:Department of Anatomy, Brighton and Sussex Medical School, Brighton, United Kingdom; Eye Unit, Salisbury District Hospital, Salisbury, United Kingdom. Electronic address: chrisschulz@doctors.org.uk.
[Ti] Título:The Value of Clinical Practice in Cadaveric Dissection: Lessons Learned From a Course in Eye and Orbital Anatomy.
[So] Source:J Surg Educ;74(2):333-340, 2017 Mar - Apr.
[Is] ISSN:1878-7452
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To test the hypothesis that there is greater benefit in a dissection-based anatomy course among those participants with clinical experience in the relevant field, and those without. DESIGN: A retrospective comparative study. SETTING: Brighton and Sussex Medical School Anatomy Department: an educational facility that provides undergraduate and postgraduate anatomy teaching using cadaveric specimens. PARTICIPANTS: All attendees (n = 40) to a postgraduate course in eye and orbital anatomy completed course evaluation forms. The course has been attended by delegates from around the country, with experience ranging from that of final year medical students to clinical fellows who have completed their specialist training in ophthalmology. RESULTS: Those participants who were practicing ophthalmology tended to be older than those who were not, with a greater amount of time spent on prior learning. Participants scored both the prosection-led and dissection-led sessions highly, with a mean combined evaluation of 8.9 (out of 10) for dissection-led learning and 9.2 for prosection-led learning. Prosection-led learning was regarded equally by those participants currently practicing in ophthalmology, and those who are not. In contrast, dissection-led learning was scored higher by those participants who were practicing ophthalmology (9.4), when compared with those not in ophthalmic practice (8.5; p = 0.018). CONCLUSIONS: The present study supports the hypothesis that the benefits of cadaveric dissection could be maximized during postgraduate surgical training. This has important implications given the trend away from cadaveric dissection in the undergraduate curriculum.
[Mh] Termos MeSH primário: Anatomia/educação
Educação de Graduação em Medicina/métodos
Oftalmologia/educação
[Mh] Termos MeSH secundário: Adulto
Cadáver
Dissecação/métodos
Olho/anatomia & histologia
Feminino
Seres Humanos
Masculino
Órbita/anatomia & histologia
Estudos Retrospectivos
Faculdades de Medicina
Estudantes de Medicina/estatística & dados numéricos
Inquéritos e Questionários
Reino Unido
[Pt] Tipo de publicação:COMPARATIVE STUDY; EVALUATION STUDIES; JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180104
[Lr] Data última revisão:
180104
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161025
[St] Status:MEDLINE


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[PMID]:29208821
[Au] Autor:Das T
[Ad] Endereço:Srimati Kanuri Santhamma Center of Vitreo retinal Disease, L V Prasad Eye Institute, Hyderabad, Telangana, India.
[Ti] Título:Redefining evidence in the management of acute post-cataract surgery endophthalmitis in India - The 2014 Adenwalla Oration, All India Ophthalmological Society.
[So] Source:Indian J Ophthalmol;65(12):1403-1406, 2017 Dec.
[Is] ISSN:1998-3689
[Cp] País de publicação:India
[La] Idioma:eng
[Ab] Resumo:The current evidence of postoperative endophthalmitis management in three important components of care-infection control, inflammation control, and prevention was reviewed, and their current relevance and application in an Indian context were evaluated. The publications from India indicated that Gram-negative bacterial and filamentous fungal infections are relatively higher. There are increasing instances of resistance to ceftazidime by Gram-negative microorganisms. Intravitreal dexamethasone limits inflammation in bacterial endophthalmitis when given together with the intravitreal antibiotics. Intracameral antibiotic could reduce postcataract surgery infection at least in less rigorous surgical environment. Systematic collection of data and periodic evaluation of the current practice against the new evidence are necessary to prevent or treat postcataract surgery endophthalmitis.
[Mh] Termos MeSH primário: Antibacterianos/uso terapêutico
Extração de Catarata/efeitos adversos
Endoftalmite
Infecções Oculares Bacterianas
Oftalmologia
Sociedades Médicas
Infecção da Ferida Cirúrgica
[Mh] Termos MeSH secundário: Doença Aguda
Gerenciamento Clínico
Endoftalmite/epidemiologia
Endoftalmite/etiologia
Endoftalmite/terapia
Infecções Oculares Bacterianas/epidemiologia
Infecções Oculares Bacterianas/etiologia
Infecções Oculares Bacterianas/terapia
Seres Humanos
Incidência
Índia/epidemiologia
Infecção da Ferida Cirúrgica/epidemiologia
Infecção da Ferida Cirúrgica/etiologia
Infecção da Ferida Cirúrgica/terapia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Anti-Bacterial Agents)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180103
[Lr] Data última revisão:
180103
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171207
[St] Status:MEDLINE
[do] DOI:10.4103/ijo.IJO_755_17


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[PMID]:29217024
[Au] Autor:Nazarali S; Mathura P; Harris K; Damji KF
[Ad] Endereço:Faculty of Medicine, University of Ottawa, Ontario, Canada.
[Ti] Título:Improving patient identification in an ophthalmology clinic using name alerts.
[So] Source:Can J Ophthalmol;52(6):564-569, 2017 Dec.
[Is] ISSN:1715-3360
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To develop a standardized process for reviewing daily patient lists and identifying potential risks of misidentification. Our goal was to develop a proactive approach to identify and eliminate risks of patient misidentification. METHODS: Assessment of current patient identification practices took place over a period of 4 weeks. Using a process map, a patient survey was developed to determine the encounter points when patient identification was confirmed. This information was used to develop a standardized protocol for review of daily appointment lists. RESULTS: Review of daily appointment lists was completed to identify potential similar/same name risks. A standardized manual process of chart review, flagging, and tracking was developed. CONCLUSIONS: The name alert process resulted in a simple manual process for identifying which patients have a higher name risk and allowed care providers to take preventative action to decrease potential risk of incorrect diagnostic testing, procedure, or medication administration.
[Mh] Termos MeSH primário: Instituições de Assistência Ambulatorial
Erros Médicos/prevenção & controle
Sistemas de Registro de Ordens Médicas
Nomes
Oftalmologia
Sistemas de Identificação de Pacientes/métodos
Segurança do Paciente
[Mh] Termos MeSH secundário: Agendamento de Consultas
Seres Humanos
Listas de Espera
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171226
[Lr] Data última revisão:
171226
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171209
[St] Status:MEDLINE


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[PMID]:29217019
[Au] Autor:Kyrillos R; Caissie M
[Ad] Endereço:Department of Ophthalmology, Faculty of Medicine, Université Laval, Quebec City, Que.; Centre Universitaire d׳Ophtalmologie (CUO) and CUO-Clinical Research Centre, Research Centre of CHU de Québec-Université Laval, Hôpital du Saint-Sacrement, Quebec City, Que.. Electronic address: ralph.kyrillos.1@ulaval.ca.
[Ti] Título:Effect of music on surgical skill during simulated intraocular surgery.
[So] Source:Can J Ophthalmol;52(6):538-542, 2017 Dec.
[Is] ISSN:1715-3360
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To evaluate the effect of Mozart music compared to silence on anterior segment surgical skill in the context of simulated intraocular surgery. DESIGN: Prospective stratified and randomized noninferiority trial. PARTICIPANTS: Fourteen ophthalmologists and 12 residents in ophthalmology. METHODS: All participants were asked to perform 4 sets of predetermined tasks on the EyeSI surgical simulator (VRmagic, Mannheim, Germany). The participants completed 1 Capsulorhexis task and 1 Anti-Tremor task during 3 separate visits. The first 2 sets determined the basic level on day 1. Then, the participants were stratified by surgical experience and randomized to be exposed to music (Mozart sonata for 2 pianos in D-K448) during either the third or the fourth set of tasks (day 2 or 3). Surgical skill was evaluated using the parameters recorded by the simulator such as "Total score" and "Time" for both tasks and task-specific parameters such as "Out of tolerance percentage" for the Anti-Tremor task and "Deviation of rhexis radius from 2.5 mm," "Roundness," and "Centering" for the Capsulorhexis task. The data were analyzed using the Wilcoxon signed-rank test. RESULTS: No statistically significant differences were noted between exposure and nonexposure for all the Anti-Tremor task parameters as well as most parameters for the Capsulorhexis task. Two parameters for the Capsulorhexis task showed a strong trend for improvement with exposure to music ("Total score" +23.3%, p = 0.025; "Roundness" +33.0%, p = 0.037). CONCLUSION: Exposure to music did not negatively impact surgical skills. Moreover, a trend for improvement was shown while listening to Mozart music.
[Mh] Termos MeSH primário: Capsulorrexe/métodos
Competência Clínica/normas
Internato e Residência
Música
Oftalmologistas
Desempenho Psicomotor/fisiologia
[Mh] Termos MeSH secundário: Adulto
Capsulorrexe/educação
Simulação por Computador
Feminino
Seres Humanos
Masculino
Meia-Idade
Oftalmologia/educação
Estudos Prospectivos
Adulto Jovem
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171226
[Lr] Data última revisão:
171226
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171209
[St] Status:MEDLINE



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