jeansemery2
jeansemery2
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AMD follow-up is a public health issue in developed countries due to aging of the population and medical demographics. Telemedicine may be a means of improving follow-up. To compare the agreement between telemedicine and in-person consultations in terms of indications for intravitreal injections in exudative AMD patients. From January 2017to April 2017, AMD patients followed on a PRN protocol at a single center, Rennes university medical center, were included. The telemedicine evaluation was read by two anonymous experts on the basis of the medical record including visual acuity and fundus photographs. The agreement between conventional follow-up and telemedicine in terms of indications for intravitreal injections, as well as interobserver agreement, were tested with the Cohen's kappa coefficient using SAS statistical software V9.4 (SAS Institute, Cary, NC). In total, 104eyes corresponding to 57consultations for 42patients were analyzed. The mean age was 82.12years (standard deviation±6.4). Recommendations for anti-VEGF were similar between the standard and telemedicine visits in 97% of cases. The Kappa coefficient was 0.8861 [0.76; 1.00], P<0.0001for agreement between telemedicine and in-person consultation. The Kappa coefficient was 0.8441 [0.70; 0.99], P<0.0001for interobserver agreement. We observed 5cases of disagreement between the two observers. The concordance was very good in our study. The few cases of disagreement resulted mainly from poorly interpretable examinations due to poor image quality, major macular changes in patients with a prior examination, and the fact that only a single cut was analyzed. AMD monitoring by telemedicine seems promising and reliable. This approach would allow better follow-up of patients with difficult access to care.AMD monitoring by telemedicine seems promising and reliable. This approach would allow better follow-up of patients with difficult access to care. To examine the effects of low-dose atropine on the choroidal thickness (CT) of young children in Shanghai, China, as well as the ocular biometrics of myopic patients. A total of 59 eyes of 35 myopic children had subfoveal CT and ocular biometry measurements taken before and after 2weeks, 4weeks, and 8weeks of treatment with 0.01% atropine. All eyes were measured using swept-source optical coherence tomography. CT and changes in it were also recorded. The choroid exhibited significant and continuous thickening under the fovea after patients were treated with 0.01% atropine. The magnitude of change in CT varied with the location and with the duration of treatment. The greatest change was observed in the fovea. There was no significant relationship between changes in subfoveal CT and axial length. Using 0.01% atropine eye drops significantly increased CT in eyes of young myopic children, by variable magnitude depending upon location.Using 0.01% atropine eye drops significantly increased CT in eyes of young myopic children, by variable magnitude depending upon location. Childhood blindness is a public health problem in developing countries. The goal of this study was to focus on the epidemiological and clinical patterns of moderate to severe, uni- or bilateral childhood blindness and severe visual impairment in the ophthalmology department of Yalgado Ouedraogo university hospital (YOUH) in Ouagadougou, Burkina Faso. We conducted a descriptive, cross-sectional analytic study based on retrospective data in the ophthalmology department of YOUH from January 1, 2010 to December 31, 2014. It included cases of childhood blindness and severe visual impairment (World Health Organisation WHO) in children 0-15 years of age. The studied variables were sociodemographic and clinical data, visual outcomes, and avoidable aspects of their blindness (WHO). The prevalence of uni- or bilateral childhood blindness and severe visual impairment was 4.36% (398 cases out of 9125 children). The male/female ratio was 1.70. Thiazovivin The mean age was 9±4 years old; 54% of children were school-age boys and girls; the most frequent causes among the 398 patients were traumatic (46.98%), infectious (12.31%) or congenital (10.05%). Most of the ocular injuries occured in boys (P<0.05) and school children (P<0.05). The injured structures resulting in childhood visual impairment were primarily the lens (30.65%) and the globe (27.64%). Childhood blindness and severe visual impairment were considered avoidable in 80.65% of cases. The type of visual disability was related to age, especially school age (P<0.0001) and to avoidability (P<0.05). Given the high prevalence of childhood blindness and severe visual impairment, early, effective management and preventive strategies should be employed.Given the high prevalence of childhood blindness and severe visual impairment, early, effective management and preventive strategies should be employed.The changing political landscape has had a significant impact on abortion training in the United States. Access to training in medical and surgical abortion has been improving over the past several decades, though significant barriers exist in training providers adequately. We sought to evaluate access to abortion training to providers, including obstetrician-gynecologists, family practice physicians, and advanced practice providers. Training in contraception, miscarriage management, medication abortion and surgical abortion procedures is a requirement for Obstetrics and Gynecology residents. Limited information exists about the details of residency training, though larger percentages of graduating residents are reporting access to comprehensive family planning training. Initiatives by groups such as Medical Students for Choice and the Kenneth J. Ryan Program have greatly improved access to abortion training by increasing opportunities for resident involvement. Abortion training opportunities exist for Family Medicine residents and advanced practice clinicians, though this training is not mandated and as such, often not standardized. In light of increasingly restrictive legislation and decreasing numbers of abortion providers, concerns exist about the sustainability of abortion training access. Other noteworthy barriers to provider training include hospital policy, lack of expert faculty, and state laws. Ensuring integrated evidence-based and standardized abortion training is important in maintaining access to a full range of family planning services.

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