RESUMEN
AIMS: Treatment delay of progressive vision-threatening conditions should be minimal. In this study, the treatment delay of patients with a rhegmatogenous retinal detachment (RRD) undergoing retinal detachment surgery was quantified, and causes for this delay were evaluated. MATERIALS AND METHODS: Consecutive patients (n=205) presenting with a primary RRD between June 2006 and June 2007 at the tertiary referral center (TRC) were interviewed. Five categories of delay were discerned in the following: 'patient delay,' 'general practitioner's delay,' 'referring ophthalmologist's delay,' 'delay at the TRC' and 'delay before surgery at the TRC'. In addition, overall delay was calculated. RESULTS: In total, 186 eyes were included in the analysis. Median overall delay between the patients' first symptoms and RRD surgery was 10 days. Almost 60% of this overall delay time was due to patient delay and the delay of the general practitioner. More than 50% of patients had a delay owing to unawareness of the symptoms. The median patient delay was significantly lower in patients with a vitreous hemorrhage and in patients with a history of a RRD in the fellow eye. CONCLUSIONS: The major reason for patient delay with a RDD was the patients' unawareness and unfamiliarity with the symptoms of a retinal detachment.
Asunto(s)
Conocimientos, Actitudes y Práctica en Salud , Aceptación de la Atención de Salud , Desprendimiento de Retina/cirugía , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Accesibilidad a los Servicios de Salud , Humanos , Masculino , Persona de Mediana Edad , Países Bajos , Estudios Prospectivos , Adulto JovenRESUMEN
PURPOSE: To gather information regarding patient's understanding of glaucoma and the manner in which patients wish to learn about the disease with the intent of improving patient education. METHODS: Forty-four of sixty randomly selected ophthalmologists (73%) asked four of their patients consecutively to complete a questionnaire about glaucoma. The selection of questions was based on focus group interviews and suggestions from several experts. Topics included knowledge about glaucoma and its treatment, the need for information, and preferred providers and methods of patient education. RESULTS: Fifty percent of the patients had 49% or less correct answers to questions about glaucoma or its treatment. Per item the correct answers ranged from 5% to 90%. Lack of knowledge was associated with low level of education, short duration of glaucoma, high age, and no preference for the Internet as method of supplying information. These variables, however, did not identify groups with a considerable lack of knowledge sufficiently accurately to target patient education. A high need for information was observed and included information about the patient's own glaucoma. Almost all patients preferred the ophthalmologist and many also a nurse or a representative of the Glaucoma Patient Society as providers of information. Written material was the preferred method. CONCLUSIONS: Patient education should address all patients. A patient education program should cover a wide range of topics with a focus on general information through written material and information tailored to the individual glaucoma patient's needs. The ophthalmologist is a key- person, but others could play an important role in patient education.
Asunto(s)
Glaucoma/psicología , Educación en Salud/métodos , Conocimientos, Actitudes y Práctica en Salud , Oftalmología/educación , Educación del Paciente como Asunto/métodos , Adulto , Anciano , Anciano de 80 o más Años , Estudios Transversales , Femenino , Glaucoma/terapia , Humanos , Servicios de Información , Masculino , Persona de Mediana Edad , Folletos , Encuestas y Cuestionarios , Materiales de EnseñanzaRESUMEN
The incidence of and background to disability claims by dentists relating to 1999 are presented on the basis of data from Movir insurance company. Possible cases of occupational related disease are indicated. Claims resulting in more than 2 weeks sick leave have been received from almost 7% of the insured dentists (excluding pregnancy related sick leave). In nearly 30% of the cases, sick leave lasted for more than 1 year (particularly due to mental and musculoskeletal disorders). Compared to the figures for 1992 long-term health related absenteeism (longer than 365 days) has increased by as much as 155%. It is estimated that at least 15% of the claims are occupationally related. Based on the 1999 data a dentist would have approximately a chance of 50% for partial or complete premature retirement due to ill health.
Asunto(s)
Odontólogos/estadística & datos numéricos , Seguro por Discapacidad/estadística & datos numéricos , Enfermedades Profesionales/epidemiología , Inhabilitación Profesional , Ausencia por Enfermedad/estadística & datos numéricos , Odontólogos/economía , Humanos , Trastornos Mentales/economía , Trastornos Mentales/epidemiología , Enfermedades Musculares/economía , Enfermedades Musculares/epidemiología , Países Bajos , Enfermedades Profesionales/economía , Inhabilitación Profesional/economíaRESUMEN
BACKGROUND: IL-16 has been described as a natural soluble CD4-ligand with immunosuppressive effects in vitro. However, little is known about the effect of IL-16 on immune responses in vivo. OBJECTIVE: In the present study, we examined the effect of IL-16 administration in a murine model of allergic asthma. Next, we determined whether these effects were mediated by modulation of CD4+ T lymphocytes. METHODS AND RESULTS: Intraperitoneal administration of IL-16 completely inhibits antigen-induced airway hyper-responsiveness and largely decreases the number of eosinophils in bronchoalveolar lavage fluid (> 90%) and airway tissue of ovalbumin-sensitized and challenged mice. Firstly, it appears that thoracic lymph node cells isolated from in vivo IL-16-treated ovalbumin-challenged animals produce less IL-4 (77%) and IL-5 (85%) upon antigenic re-stimulation, when compared to vehicle-treated mice. Secondly, pre-incubation of lymphocytes with IL-16 in vitro reduces antigen-induced proliferation (55%) and Th2-type cytokine production (IL-4; 56%, IL-5; 77%). Thirdly, the presence of IL-16 during priming cultures of TCR transgenic T cells (DO11.10), reduces IL-4 (33%) and IL-5 (35%), but not IL-10 and IFNgamma levels upon re-stimulation. CONCLUSION: It can be concluded that IL-16 has potent immunosuppressive effects on a Th2dominated allergic airway response.