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[PMID]:29187360
[Au] Autor:Fell G
[Ad] Endereço:Town Hall, Sheffield S1 2HH, UK.
[Ti] Título:The NHS must act on bevacizumab, for patients' sake.
[So] Source:BMJ;359:j5427, 2017 11 29.
[Is] ISSN:1756-1833
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Inibidores da Angiogênese/economia
Bevacizumab/economia
Análise Custo-Benefício/legislação & jurisprudência
Degeneração Macular/tratamento farmacológico
Oftalmologistas/ética
Ranibizumab/farmacologia
Proteínas Recombinantes de Fusão/farmacologia
Medicina Estatal/legislação & jurisprudência
[Mh] Termos MeSH secundário: Inibidores da Angiogênese/farmacologia
Bevacizumab/farmacologia
Acesso aos Serviços de Saúde
Seres Humanos
Degeneração Macular/economia
Receptores de Fatores de Crescimento do Endotélio Vascular/antagonistas & inibidores
Reino Unido/epidemiologia
[Pt] Tipo de publicação:LETTER
[Nm] Nome de substância:
0 (Angiogenesis Inhibitors); 0 (Recombinant Fusion Proteins); 15C2VL427D (aflibercept); 2S9ZZM9Q9V (Bevacizumab); EC 2.7.10.1 (Receptors, Vascular Endothelial Growth Factor); ZL1R02VT79 (Ranibizumab)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171201
[St] Status:MEDLINE
[do] DOI:10.1136/bmj.j5427


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[PMID]:29350893
[Au] Autor:Jovancevic L; Canadanovic V; Savovic S; Zvezdin B; Komazec Z
[Ti] Título:Silent sinus syndrome: One more reason for an ophthalmologist to have a rhinologist as a good friend.
[So] Source:Vojnosanit Pregl;74(1):59-63, 2017 Jan.
[Is] ISSN:0042-8450
[Cp] País de publicação:Serbia
[La] Idioma:eng
[Mh] Termos MeSH primário: Enoftalmia
Seio Maxilar
Oftalmologistas
Doenças dos Seios Paranasais
[Mh] Termos MeSH secundário: Diagnóstico Diferencial
Técnicas de Diagnóstico Oftalmológico
Enoftalmia/diagnóstico por imagem
Enoftalmia/cirurgia
Seres Humanos
Comunicação Interdisciplinar
Seio Maxilar/diagnóstico por imagem
Seio Maxilar/cirurgia
Procedimentos Cirúrgicos Otorrinolaringológicos
Doenças dos Seios Paranasais/diagnóstico por imagem
Doenças dos Seios Paranasais/cirurgia
Valor Preditivo dos Testes
Síndrome
Tomografia Computadorizada por Raios X
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180213
[Lr] Data última revisão:
180213
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180120
[St] Status:MEDLINE
[do] DOI:10.2298/VSP141118141J


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[PMID]:29217021
[Au] Autor:Ross M; Deschênes J
[Ad] Endereço:Department of Ophthalmology, McGill University Health Center, McGill University, Montreal, Que.. Electronic address: michael.ross4@mail.mcgill.ca.
[Ti] Título:Practice patterns in the interdisciplinary management of corneal abrasions.
[So] Source:Can J Ophthalmol;52(6):548-551, 2017 Dec.
[Is] ISSN:1715-3360
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To characterize the treatment and follow-up patterns of corneal abrasions at an academic health centre. METHODS: This is a retrospective review of 90 cases of corneal abrasions over a 2-year period at a tertiary care academic hospital, of which 75 were seen by the ophthalmology department. All consultations primarily for corneal abrasion, as determined by the emergency department physician, were included in the study. Information on treatment regimen, corneal findings by emergency and ophthalmology physicians, time between follow-ups, and final outcomes was collected. RESULTS: Seventy-five patients were seen by ophthalmology a median of 1 day after the emergency room visit. Twenty-five of these patients did not arrive for their subsequent follow-up appointment. Twenty-two of the abrasions were healed by the time of the ophthalmology examination, 51 patients had unhealed corneal abrasions, and 2 had corneal ulcers. Management was changed in 29 of the patients by ophthalmology. The most common management changes were hypertonic saline ointment for prophylaxis or treatment of recurrent erosion syndrome, followed by bandage contact lenses for comfort. CONCLUSIONS: Corneal abrasions are a common condition, and practice patterns for follow-up vary widely. Although the vast majority of patients do very well and likely would heal on their own without ophthalmology referral, it seems reasonable that patients with corneal abrasions are assessed once by an ophthalmologist immediately or possibly up to 1-2 days after the initial emergency visit, depending on the individual patient circumstances.
[Mh] Termos MeSH primário: Lesões da Córnea/terapia
Epitélio Anterior/lesões
Oftalmologistas/estatística & dados numéricos
Equipe de Assistência ao Paciente
Padrões de Prática Médica/estatística & dados numéricos
[Mh] Termos MeSH secundário: Centros Médicos Acadêmicos
Adolescente
Adulto
Idoso
Idoso de 80 Anos ou mais
Bandagens
Lentes de Contato
Serviço Hospitalar de Emergência
Feminino
Seres Humanos
Masculino
Meia-Idade
Pomadas
Equipe de Assistência ao Paciente/estatística & dados numéricos
Estudos Retrospectivos
Solução Salina Hipertônica/administração & dosagem
Centros de Atenção Terciária
Cicatrização
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Nm] Nome de substância:
0 (Ointments); 0 (Saline Solution, Hypertonic)
[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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[PMID]:29194229
[Au] Autor:Slota C; Davis SA; Blalock SJ; Carpenter DM; Muir KW; Robin AL; Sleath B
[Ti] Título:Patient-Physician Communication on Medication Cost during Glaucoma Visits.
[So] Source:Optom Vis Sci;94(12):1095-1101, 2017 Dec.
[Is] ISSN:1538-9235
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:SIGNIFICANCE: This article is the first to investigate the nature of medication cost discussions between ophthalmologists and glaucoma patients. Only 87 of the 275 office visits analyzed had a discussion of medication cost. Providers should consider discussing medication cost with patients to identify potential cost-related barriers to medication use. PURPOSE: Glaucoma is an incurable chronic eye disease affecting a growing portion of the aging population. Some of the most commonly utilized treatments require lifelong use, requiring high patient adherence to ensure effectiveness. There are numerous barriers to glaucoma treatment adherence in the literature, including cost. The aim of this secondary analysis was to describe the frequency and nature of patient-physician communication regarding medication cost during glaucoma office visits. METHODS: This was a mixed-methods secondary analysis of video-recorded participant office visits (n = 275) from a larger observational study of glaucoma communication. We analyzed medical information, demographic characteristics, and interviewer-administrated questionnaires, as well as verbatim transcripts of interviews. RESULTS: Only 87 participants discussed medication cost during their glaucoma office visit. The majority of the subjects who discussed cost had mild disease severity (51%), took one glaucoma medication (63%), and had Medicare (49%) as well as a form of prescription insurance (78%). The majority of glaucoma office visits did not discuss medication cost, and providers often did not ask about cost problems. Of the few conversations related to cost, most focused on providers offering potential solutions (n = 50), medical and prescription service coverage (n = 41), and brand or generic medication choices (n = 41). CONCLUSIONS: Our findings are similar to previous studies showing few patients have conversations with providers about the cost of glaucoma medications. Providers should consider bringing up medication cost during glaucoma office visits to prompt a discussion of potential cost-related barriers to medication use.
[Mh] Termos MeSH primário: Anti-Hipertensivos/economia
Comunicação
Custos de Medicamentos
Glaucoma/economia
Oftalmologistas/estatística & dados numéricos
Participação do Paciente/estatística & dados numéricos
Relações Médico-Paciente
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Feminino
Glaucoma/tratamento farmacológico
Seres Humanos
Masculino
Meia-Idade
Visita a Consultório Médico
Cooperação do Paciente
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antihypertensive Agents)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171220
[Lr] Data última revisão:
171220
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171202
[St] Status:MEDLINE
[do] DOI:10.1097/OPX.0000000000001139


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[PMID]:28784553
[Au] Autor:Han E; Baisiwala S; Jain A; Bundorf MK; Pershing S
[Ad] Endereço:Department of Ophthalmology, Byers Eye Institute, Stanford University School of Medicine, Palo Alto, California.
[Ti] Título:An Analysis of Medicare Reimbursement to Ophthalmologists: Years 2012 to 2013.
[So] Source:Am J Ophthalmol;182:133-140, 2017 Oct.
[Is] ISSN:1879-1891
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: To analyze trends in utilization and payment of ophthalmic services in the Medicare population for years 2012 and 2013. DESIGN: Retrospective, cross-sectional study. METHODS: A retrospective cross-sectional observational analysis was performed using publicly available Medicare Physician and Other Supplier aggregate file and the Physician and Other Supplier Public Use File. Variables analyzed included aggregate beneficiary demographics, Medicare payments to ophthalmologists, ophthalmic medical services provided, and the most common Medicare-reimbursed ophthalmic services. RESULTS: In 2013, total Medicare Part B reimbursement for ophthalmology was $5.8 billion, an increase of 3.6% from the previous year. From 2012 to 2013, the total number of ophthalmology services rendered increased by 2.2%, while average dollar amount reimbursed per ophthalmic service decreased by 5.4%. The top 5 highest reimbursed services accounted for 85% of total ophthalmic Medicare payments in 2013, an 11% increase from 2012. During 2013, drug reimbursement represented 32.8% of the total Medicare payments to ophthalmologists. Ranibizumab and aflibercept alone accounted for 95% of the entire $1.9 billion in drug reimbursements ophthalmologists in 2013. CONCLUSION: Medicare Part B reimbursement for ophthalmologists was primarily driven by use of anti-vascular endothelial growth factor (anti-VEGF) injections from 2012 to 2013. Of the total drug payments to ophthalmologists, biologic anti-VEGF agents ranibizumab and aflibercept accounted for 95% of all drug reimbursement. This is in contrast to other specialties, in which drug reimbursement represented only a small portion of Medicare reimbursement.
[Mh] Termos MeSH primário: Assistência à Saúde/tendências
Reembolso de Seguro de Saúde/tendências
Medicare Part B/economia
Oftalmologistas/economia
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Inibidores da Angiogênese/economia
Estudos Transversais
Uso de Medicamentos/tendências
Feminino
Pesquisa sobre Serviços de Saúde
Seres Humanos
Masculino
Medicare Part B/tendências
Oftalmologistas/tendências
Ranibizumab/economia
Receptores de Fatores de Crescimento do Endotélio Vascular
Proteínas Recombinantes de Fusão/economia
Estudos Retrospectivos
Estados Unidos
Fator A de Crescimento do Endotélio Vascular/antagonistas & inibidores
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Angiogenesis Inhibitors); 0 (Recombinant Fusion Proteins); 0 (VEGFA protein, human); 0 (Vascular Endothelial Growth Factor A); 15C2VL427D (aflibercept); EC 2.7.10.1 (Receptors, Vascular Endothelial Growth Factor); ZL1R02VT79 (Ranibizumab)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171003
[Lr] Data última revisão:
171003
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170809
[St] Status:MEDLINE


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[PMID]:28774517
[Au] Autor:Symes RJ; Mikelberg FS
[Ad] Endereço:University of British Columbia, The Eye Care Centre, Vancouver, B.C. Electronic address: richsymes@hotmail.com.
[Ti] Título:Normal tension glaucoma management: a survey of contemporary practice.
[So] Source:Can J Ophthalmol;52(4):361-365, 2017 Aug.
[Is] ISSN:1715-3360
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: The aim of this study was to investigate contemporary practice patterns with respect to normal tension glaucoma (NTG) management and to determine whether the 2 largest NTG trials have influenced ophthalmologists' clinical practice. METHODS: A survey questionnaire was sent to ophthalmologists via the American Glaucoma Society, the Canadian Glaucoma Society, and the Canadian Ophthalmological Society. The questionnaire was designed to investigate ophthalmologists' usual practice with respect to NTG and the extent to which practice has been influenced by the Collaborative Normal Tension Glaucoma Study (CNTGS) and the Low pressure Glaucoma Treatment Study (LoGTS). RESULTS: In total, 419 ophthalmologists completed the survey. Of these, 264 respondents were glaucoma subspecialists. The survey showed that 95% and 64% of ophthalmologists were familiar with the CNTGS and the LoGTS, respectively. Of the respondents, 70% indicated that they would initiate treatment in mild-to-moderate NTG without waiting for documented disease progression. Of the respondents, 61% of the total surveyed and 50% of the glaucoma subspecialists felt that the LoGTS results had no impact on their usual clinical practice. The first-choice topical drug for NTG was a prostaglandin analogue (88% of respondents) or brimonidine (10% of respondents). CONCLUSIONS: Most ophthalmologists treat NTG more aggressively than recommended by the CTNGS protocol. Most ophthalmologists felt that the LoGTS results had no impact on their normal clinical practice. The prostaglandin analogues are, by far, the most popular choice of drug for contemporary management of NTG.
[Mh] Termos MeSH primário: Competência Clínica
Gerenciamento Clínico
Inquéritos Epidemiológicos/métodos
Glaucoma de Baixa Tensão/terapia
Oftalmologistas/normas
[Mh] Termos MeSH secundário: Canadá
Feminino
Seres Humanos
Pressão Intraocular
Glaucoma de Baixa Tensão/diagnóstico
Glaucoma de Baixa Tensão/fisiopatologia
Masculino
Estados Unidos
Testes de Campo Visual
Campos Visuais
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171102
[Lr] Data última revisão:
171102
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170805
[St] Status:MEDLINE


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[PMID]:28671928
[Au] Autor:Hacopian AG; Rushing LC; Chuang AZ; Bell NP; Kumar KS; Feldman RM
[Ad] Endereço:*Ruiz Department of Ophthalmology and Visual Science, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth) †Robert Cizik Eye Clinic, Houston, TX.
[Ti] Título:Examiner Handedness and the Effects on Intraocular Pressure Readings Using the Tono-Pen XL.
[So] Source:J Glaucoma;26(8):718-720, 2017 Aug.
[Is] ISSN:1536-481X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: To assess the effect of examiner handedness on intraocular pressure (IOP) readings using the Tono-Pen XL in eyes without corneal pathology or previous ocular surgeries. PATIENTS AND METHODS: Patients 18 years of age or older were included in this prospective study. Participants who had a history of corneal conditions or other characteristics that would prevent reliable IOP measurements were excluded. Five experienced examiners, 2 right-hand dominant and 3 left-hand dominant, took bilateral IOP measurements with a Tono-Pen XL. Each participant was tested by 2 examiners, 1 left-handed and 1 right-handed, in a random order. The time between each examiner's measurements was 15 minutes. A paired t test was used to compare IOP differences between "near" (right eye for right-hand or left eye for left-hand dominant examiner) and "far" (right eye by left-hand or left eye by right-hand dominant examiner) measurements for each eye. RESULTS: Forty-six participants with a mean age of 33.8 years (±12.8) were enrolled. No significant difference in IOP between near and far eyes was found (IOP difference=IOPfar-IOPnear=-0.11 [±2.74] mm Hg; P=0.70). Right-hand dominant examiners consistently measured significantly higher IOP (0.83±2.03 mm Hg; P=0.008) compared with left-hand dominant examiners, regardless of the relative position of the eye with respect to the examiner. CONCLUSIONS: The results suggest that IOP readings are not influenced by the positioning of the patient relative to the dominant hand of the examiner.
[Mh] Termos MeSH primário: Lateralidade Funcional/fisiologia
Pressão Intraocular/fisiologia
Tonometria Ocular/instrumentação
[Mh] Termos MeSH secundário: Adulto
Feminino
Glaucoma/diagnóstico
Seres Humanos
Masculino
Meia-Idade
Oftalmologistas
Estudos Prospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171106
[Lr] Data última revisão:
171106
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170704
[St] Status:MEDLINE
[do] DOI:10.1097/IJG.0000000000000721


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[PMID]:28643708
[Au] Autor:Gogate P; Biswas P; Natarajan S; Ramamurthy D; Bhattacharya D; Golnik K; Nayak BK
[Ad] Endereço:All India Ophthalmology Society, New Delhi; Padmashree Dr D Y Patil Medical College; Dr. Gogate's Eye Clinic, Community Eye Care Foundation, Pune, Maharashtra, India.
[Ti] Título:Residency evaluation and adherence design study: Young ophthalmologists' perception of their residency programs - Clinical and surgical skills.
[So] Source:Indian J Ophthalmol;65(6):452-460, 2017 Jun.
[Is] ISSN:1998-3689
[Cp] País de publicação:India
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Residency training is the basis of good clinical and surgical practice. PURPOSE: The aim is to know the demographics, training experience, and perception of young ophthalmologists to improve the present residency programs in India. SETTING: Young ophthalmologists trained in India. METHODS: A survey was conducted by the Academic and Research Committee of the All India Ophthalmology Society, in 2014-2016 of young ophthalmologists (those trained between 2002 and 2012, with 2-10 years' postresidency experience) to gauge teaching of clinical and surgical skills during the postgraduate residency program. STATISTICAL ANALYSIS: Statistical Package for Social Sciences version 16. RESULTS: Of the 1005 respondents, 531 fulfilled inclusion criteria. Average age was 32.6 years (standard deviation [SD] 4). On a scale of 0-10, clinical skills teaching was graded as (mean, SD): Slit lamp examination (7.2, SD 2.8), indirect ophthalmoscopy (6.2, SD 3.3), gonioscopy (5.7, SD 3.4), perimetry (6.2, SD 3.2), optical coherence tomography (4.6, SD 4), and orthoptic evaluation (4.3, SD 3.1). The mean (SD) and median of surgeries performed independently was intracapsular cataract extraction 3.0 (14.9), 0; extracapsular cataract extraction 39.9 (53.2), 18; small incision cataract surgery 75.3 (64.4), 55; phacoemulsification 30 (52.6), 1; pterygium excision 31.5 (43.5), 15; dacryocystectomy 20.3 (38.1), 4; dacryocystorhinostomy 11.7 (26.2), 2; chalazion 46.4 (48.3), 30; trabeculectomies 4 (14.9), 0; strabismus correction 1.4 (4.9), 0; laser-assisted in situ Keratomileusis 1.5 (12.2), 0; retinal detachment 1.5 (12.5), 0; vitrectomy 3.0 (17.0), 0; keratoplasty 5.2 (17.8), 0; eyelid surgery 8.6 (18.9), 2 and ocular emergencies 41.7 (52.4), 20. Observed and assisted surgeries were more common. However, the range of grading was 0-10 in all categories. CONCLUSION: Residency training in India varies considerably from program to program. Standardization is needed to assure all graduates are competent and render consistent quality of service.
[Mh] Termos MeSH primário: Competência Clínica
Educação de Pós-Graduação em Medicina/métodos
Internato e Residência/métodos
Oftalmologistas/normas
Oftalmologia/educação
[Mh] Termos MeSH secundário: Adulto
Feminino
Seguimentos
Seres Humanos
Índia
Masculino
Oftalmologistas/educação
Estudos Retrospectivos
Inquéritos e Questionários
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171012
[Lr] Data última revisão:
171012
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170624
[St] Status:MEDLINE
[do] DOI:10.4103/ijo.IJO_643_16


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[PMID]:28617721
[Au] Autor:Winkler NS; Damento GM; Khanna SS; Hodge DO; Khanna CL
[Ad] Endereço:*Mayo Medical School, Mayo Clinic College of Medicine †Department of Ophthalmology, Mayo Clinic, Rochester, MN ‡Biostatistics Unit, Mayo Clinic, Jacksonville, FL.
[Ti] Título:Analysis of a Physician-led, Team-based Care Model for the Treatment of Glaucoma.
[So] Source:J Glaucoma;26(8):702-707, 2017 Aug.
[Is] ISSN:1536-481X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: To determine the effect of a protocol for a new physician-led, team-based glaucoma care model implemented in 2008 at Mayo Clinic's campus in Rochester, Minnesota (MCR), to increase conformance with the American Academy of Ophthalmology (AAO) Preferred Practice Pattern guidelines for treatment of primary open-angle glaucoma. METHODS: Records of 591 patients with newly diagnosed glaucoma were assessed retrospectively for the completion of 9 AAO Preferred Practice Pattern recommended metrics including measured corneal thickness, intraocular pressure (IOP), cup to disk ratio, visual acuity, recorded IOP target, gonioscopy, fundus photos, ocular coherence tomography, and visual field in the 3 years before and 3 years after protocol implementation. Treatment by the glaucoma care team at MCR was compared with treatment at a community-based general ophthalmology practice and with a group of comprehensive ophthalmologists at MCR without team care, which served as controls. RESULTS: Adherence to AAO recommendations increased for the documentation of target IOP (+24%, 42.6% to 66.7%; P=0.007), gonioscopy (+27%, 66.7% to 93.3%; P≤0.001), fundus photos (+29%, 44.4% to 73.3%; P≤0.001), and ocular coherence tomography (+20%, 48.1% to 68.0%; P=0.02) after protocol initiation. No change in pattern of testing occurred in the control groups without team care during the same time period. Type and severity of glaucoma were similar between MCR and community practice. CONCLUSIONS: An increase in compliance with AAO guidelines was found after implementation of our protocol for a physician-led, team-based care model to standardize glaucoma care among providers.
[Mh] Termos MeSH primário: Glaucoma de Ângulo Aberto/diagnóstico
Glaucoma de Ângulo Aberto/terapia
Oftalmologistas/organização & administração
Optometria/organização & administração
Equipe de Assistência ao Paciente/organização & administração
Padrões de Prática Médica
[Mh] Termos MeSH secundário: Adulto
Idoso
Feminino
Gonioscopia
Fidelidade a Diretrizes
Implementação de Plano de Saúde
Seres Humanos
Pressão Intraocular/fisiologia
Masculino
Oftalmologia/normas
Estudos Retrospectivos
Sociedades Médicas/organização & administração
Tonometria Ocular
Estados Unidos
Acuidade Visual/fisiologia
Campos Visuais/fisiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171116
[Lr] Data última revisão:
171116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170616
[St] Status:MEDLINE
[do] DOI:10.1097/IJG.0000000000000689



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