Quality and targeting of new referrals for ocular complications of diabetes from primary care to a public hospital ophthalmology service in Western Sydney, Australia.

Patients with diabetes require regular examination for eye disease, usually in primary care settings. Guidelines recommend patients with at least moderate non-proliferative diabetic retinopathy (NPDR) be referred to an ophthalmologist for treatment; however, poorly targeted referrals lead to access blocks. The quality of new referrals associated with diabetes to a public ophthalmology service in Sydney, New South Wales, Australia, were assessed for referral completeness and targeting.

Telemedicine for adolescents with type 1 diabetes.

Diabetes is the third most common chronic disease in the pediatric population and diabetes management in adolescents presents a unique challenge for health care providers. The purpose of this article is to define telemedicine, review a variety of telemedicine intervention studies in the adolescent population, and interpret those results in the context of the current health care climate. Clinicians and researchers will be provided with education related to adolescent needs and telemedicine interventions so that telemedicine can be used effectively to promote the health of adolescents with diabetes.

Arboreal habitat structure affects locomotor speed and perch choice of white-footed mice (Peromyscus leucopus).

Arboreal habitats pose several challenges for locomotion resulting from narrow cylindrical surfaces, steep slopes, and secondary branches that can form obstructions. We used laboratory trials to test whether different diameters, slopes, or complexity of branches affected maximum speeds and perch choice of the semi-arboreal white-footed mouse (Peromyscus leucopus). We tested locomotor performance of mice running horizontally and up and down 45° slopes for cylindrical artificial branches with five diameters ranging from 10 to 116 mm and on a subset of diameters for cylinders that were horizontal and had pegs (e.

Prognostic values of B-type natriuretic peptide in severe sepsis and septic shock.

Objective: To investigate the changes in B-type natriuretic peptide concentrations in patients with severe sepsis and septic shock and to investigate the value of B-type natriuretic peptide in predicting intensive care unit outcomes.

Design: Prospective observational study.

Setting: General intensive care unit.

Guidelines for the management of head injuries in remote and rural Alaska.

Numerous recommendations on the initial evaluation and treatment of the head injured patient have been proposed over the last several years. Most assume there is readily available access to computed tomography and neurosurgical specialists. Many clinicians in Alaska must evaluate and begin treatment of head injured patients in circumstances quite different from this.

Systematic distortions of auditory space perception following prolonged exposure to broadband noise.

Perceptual distortions referred to as aftereffects may arise following exposure to an adapting sensory stimulus. The study of aftereffects has a long and distinguished history [Kohler and Wallach, Proc. Am.

The nature and distribution of errors in sound localization by human listeners.

Measurement of localization performance will reflect errors that relate to the sensory processing of the cues to sound location and the errors associated with the method by which the subject indicates the perceived location. This study has measured the ability of human subjects to localize a short noise burst presented in the free field with the subject indicating the perceived location by pointing their nose towards the source. Subjects were first trained using a closed loop training paradigm which involved instantaneous feedback as to the accuracy of head pointing which resulted in the reduction of residual localization errors and a rapid acquisition of the task by the subjects.

The Patient-Specific Functional Scale: measurement properties in patients with knee dysfunction.

Background And Purpose: Assessing disability is important, and numerous interviewer-assisted and self-report questionnaires are used to accomplish this task. These questionnaires can be classified as being generic, condition or disease specific, or patient specific. The purpose of this study was to determine test-retest reliability, construct validity, and sensitivity to change of the Patient-Specific Functional Scale (PSFS) when applied to patients with knee dysfunction.

Perforation of the globe during the injection of local anesthesia.

Perforation of the globe occurred during injection of local anesthetic into the eyelids. No such occurrence has been reported, although there have been reports of perforation of the globe during retrobulbar injection (five cases), while injecting anesthetic around the superior rectus muscle (one case), and when placing the superior rectus bridle suture (four cases). The prognosis is good if the perforation is recognized and treated immediately.

The effect of hospitalization on intraocular pressure.

Thirteen subjects with open-angle glaucoma or ocular hypertension (five men and eight women, ranging in age from 51 to 73 years) were hospitalized for four to six days during which their intraocular pressures were measured four times a day (8 AM, 2 PM, 6 PM, and 10 PM). After leaving the hospital they returned to the outpatient clinic on several occasions for similar measurements (8 AM). Eight patients were taking timolol, pilocarpine, or both and five were receiving no treatment.

Ophthalmic screening of 38,000 children, age 1 to 2 1/2 years, in child welfare clinics.

Screening of 38,000 infants, age 1 to 2 1/2 years, showed a prevalence of 1.3% of strabismus and 0.5% of strabismic amblyopia.

Prevalence of refractive errors in adults over 40: a survey of 8102 eyes.

The prevalence of refractive errors was studied in an adult rural population. Of the 8102 eyes studied 18-4% were myopic, 57-1% were emmetropic, and 24-5% were hypermetropic. Mild myopia was commoner in males than in females, and mild hypermetropia was commoner in females than in males.

A data retrieval system for the eye clinic. II. The programmed system.

The programmed system of a data retrieval system for the eye clinic is described. The system uses an IBM 370/168 computer, involves programmes to minimize the possibility of entering errors and a magnetic tape back-up system to reduce the cost of storing rarely required material and as a safeguard against the accidental erasion of material on disc.

A data retrieval system for the eye clinic. I. Clinical aspects.

The use of a data retrieval system for patients' ophthalmic records is described. Input is by using simple forms and output is in batch. The system is adaptable for on-line use as soon as a terminal is established in the clinic.

The computer in clinical research. Prevalence of glaucoma.

The prevalence of glaucoma in a rural population of 6232 people over the age of 40 years, including patients with previously diagnosed glaucoma, was found to be 1.21%. There were 41 cases of open-angle glaucoma compared to 32 cases of angle-closure glaucoma.

Applications of nuclear medicine in ophthalmology.

Diagnostic techniques using radioactive isotopes can be used for the investigation of cerebral, orbital and intraocular tumours and for the dynamic study of tear flow. The value of such techniques in the study of obstruction of the nasolacrymal system (particularly partial and functional obstructions) has been established and the possibility of using Tc99m clearance for the investigation of dry eyes is being investigated.

Mixed glaucoma.

Two hundred and sixty-seven eyes which underwent peripheral iridectomy for presumed angle-closure glaucoma were investigated. The diagnosis of angle-closure glaucoma was confirmed postoperatively in 258 eyes, in 201 of which the intraocular pressure became normal without further treatment and in 57 of which the postiridectomy IOP was elevated because of visible damage to the anterior chamber angle. Three eyes had open-angle glaucoma with a narrow angle.

Expulsive hemorrhage: management without sclerotomy.

Expulsive hemorrhage occurring during cataract extraction was successfully treated by immediate wound closure, without evacuation of blood through the sclera. Only two such cases have been reported previously. Modern micro-surgical techniques are not ideal for the management of this condition.

Oculomotor palsy following dental anesthesia.

Paralysis of the right third and fourth cranial nerves, lasting for about six weeks, occurred in a patient following the injection of procaine hydrochloride in the area of the right superior alveolar artery. Ocular complications of dental anesthesia are rare and are probably caused by intra-arterial injection of anesthetic that reaches the orbit via an anastomosis between the middle meningeal and ophthalmic arteries. Such complications include transient oculomotor palsies and permanent or transient loss of vision.

[Closed angle glaucoma induced by phospholine iodide and epinephrine in a case of open angle glaucoma].

A patient suffering from open angle glaucoma was treated with topical phospholine iodide and epinephrine. Before treatment the anterior chamber was deep and the angle wide open in both eyes. Two weeks after beginning treatment there was an acute elevation of pressure to 52 mm hg in the right eye accompanied by myopia, shallowing of the anterior chamber and closure of the angle.