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Use of Electronic Health Records, Disease Registries, and Health Insurance Databases in Ophthalmology
Published in Ching-Yu Cheng, Tien Yin Wong, Ophthalmic Epidemiology, 2022
Rachel Marjorie Wei Wen Tseng, Grace May Chuang, Zhi Da Soh, Yih-Chung Tham
Countries such as the USA, Germany, and the UK are actively contributing their EHRs to different data registries. Table 1.1 summarizes the ophthalmic data registries currently available. First, the Intelligent Research In Sight (IRIS) registry is known to be the first established ophthalmic clinical registry in the USA (7). The purpose of IRIS is to aid clinical performance from screening to follow-up and care interventions using participants’ EHR data, including patient demographics, past medical history, diagnoses, and medications (7). Secondly, the Smart Eye database (SMEYEDAT) registry was established in Germany as a real-time ophthalmology data warehouse that combines patients’ health records and imaging data for all types of ocular diseases and conditions (8). Thirdly, the Sight Outcomes Research Collaborative (SOURCE) registry is a US-based registry which is built upon an EHR consortium of several academic medical centers in the USA (i.e., University of Michigan Kellogg Eye Center, Stanford University Byers Eye Institute, Moran Eye Center, etc.) (9). Data such as patient demographics, billing codes, imaging data, and diagnostic tests were included in this registry (9). On the other hand, the Save Sight Registry is a culmination of different registries (of different countries), including the Fight Retinal Blindness Registry and Fight Tumour Blindness Registry. The Fight Retinal Blindness Registry in particular focuses on ocular diseases that affect the retina, such as diabetic retinopathy (DR) and retinal vein occlusion.
Comparative Anatomy and Physiology of the Mammalian Eye
Published in David W. Hobson, Dermal and Ocular Toxicology, 2020
In addition to its role in the control of light entering the posterior portions of the eye, the iris also actively participates in inflammation. Inflammation of the iris is termed iritis, but if the inflammation involves both the iris and the ciliary body it is termed iridocyclitis, or more commonly anterior uveitis. Because of its vascular nature, the iris is very sensitive to systemic toxins and infectious agents. In addition, a reflex pathway is present that results in inflammation of the anterior uveal tissue when the sensory innervation of the cornea, via the fifth cranial nerve, is stimulated. It is for this reason that animals with severe corneal disease often have a concomitant anterior uveitis. Also, when ulcerated, the cornea may allow passage of exotoxins into the anterior chamber, or alter the aqueous humor pH or oxygenation and result in inflammation. The clinical signs of inflammation are miosis, ocular hyperemia, increased protein, and cells in the aqueous humor, photophobia, and either an increase and/or a decrease in the intraocular pressure, depending on the species involved and the duration of the inflammation.
Care of Critically Ill Patients with HIV
Published in Cheston B. Cunha, Burke A. Cunha, Infectious Diseases and Antimicrobial Stewardship in Critical Care Medicine, 2020
Joseph Metmowlee Garland, Andrew Levinson, Edward Wing
The Immune Reconstitution Inflammatory Syndrome (IRIS) is a complication of initiation of ART in a severely immunocompromised patient. IRIS can be defined as either a paradoxical worsening of treated OIs (“paradoxical IRIS”), or the unmasking of previously subclinical, untreated infections (“unmasking IRIS”). IRIS is described as occurring any time between 4 weeks and one year after initiating ART, though rare otherwise clinically compatible cases may present earlier or later than this. There is significant morbidity to IRIS, as up to 50% of IRIS cases require hospitalization, and often require extensive testing and both diagnostic and therapeutic procedures [113].
Digital health technology used in emergency large-scale vaccination campaigns in low- and middle-income countries: a narrative review for improved pandemic preparedness
Published in Expert Review of Vaccines, 2023
Paula Mc Kenna, Lindsay A. Broadfield, Annik Willems, Serge Masyn, Theresa Pattery, Ruxandra Draghia-Akli
Many people worldwide, especially those living in LMICs, lack an official proof of identity [63]. For vaccine delivery, it is critical to reliably verify the identity of the individuals to avoid inaccurate vaccine tracking and delivery and to reduce duplicate medical records and record falsification [64,65]. Digital health tools help provide reliable identification in a safe way in a large-scale vaccination campaign in emergency settings. Biometrics are commonly used for identification with various technologies developed and implemented to identify individuals using fingerprints, iris, face, and voice recognition [66]. Based upon the learnings from recent Ebola outbreaks, it is important that biometric tools can be contactless, like iris scanning or facial recognition [27]. In the case of highly transmissible infectious pathogens, fingerprinting can represent a risk of transmission and may require additional hygiene measures to reduce this risk [67]. Numerous biometric-based identification methods exist and could be integrated into a tool for a vaccine campaign.
Current status and challenges in establishing reference intervals based on real-world data
Published in Critical Reviews in Clinical Laboratory Sciences, 2023
Sijia Ma, Juntong Yu, Xiaosong Qin, Jianhua Liu
At this stage, the establishment of iRIs is characterized by problems such as non-uniformity in steps and the numerous algorithms of modern models without any official guidance on the selection of a suitable algorithm. Although a multitude of studies has been done on indirect methods for establishing RIs, the accuracy of their findings needs verification, owing to a lack of uniform standards. To resolve the aforementioned problems, this paper will summarize several general steps for establishing iRIs based on RWD: data extraction, data cleaning, describing data distributions, statistical processing, validation, and publication of iRIs. Furthermore, we provide a brief overview of various statistical methods and their advantages and disadvantages, outline the current state of research on establishing iRIs based on RWD, and provide a reference for laboratory workers on the subject as well.
The influence of luminous intensity on the eyelid aperture and measurement of the margin reflex distance
Published in Orbit, 2022
Martha Pereira Lima Lang, Diane Ruschel Marinho, Fernando Procianoy
Another aspect considered in the study was the color of the iris and its relationship with the response to light intensity. There is a belief that the color of the iris can influence sensitivity to light.3 In our sample, iris color showed no association with the manifestation of palpebral occlusion caused by light. Although upper eyelid position is resultant from the balance of levator muscle, Muller’s muscle, and orbicularis muscle contraction, those were not measured in this study. We believe that orbicularis muscle contraction was apparently responsible for the reduction in the MRD, thus demonstrating the effect of photophobia. Individuals were not questioned about the subjective sensation of discomfort. It is possible that higher intensities than those evaluated in this study cause a greater reduction in the palpebral opening, which can be better studied in the future.