Biomedical subjects

Hussein Hollands

Publications and source records attributed to Hussein Hollands.

5 recordsLinked to original sources

PubMed2006

Risk factors for posterior vitreous detachment: a case-control study.

PURPOSE: To identify possible risk factors for the development of posterior vitreous detachment (PVD). DESIGN: Retrospective case-control study. METHODS: A total of 138 cases with PVD and 114 age-matched controls were accrued from two different sites. Demographic, medical, ocular, and lifestyle data were obtained through chart review, questionnaires, and clinical examination. A 108-item semiquantitative food frequency questionnaire was also used to estimate macro- and micronutrient intake. Univariate and multivariate regression analyses were employed to identify variables significantly associated with the main outcome measure of PVD. Subgroup analysis of gender-specific variables was performed. RESULTS: Among all patients, multivariate regression analysis demonstrated female gender (odds ratio [OR] = 2.01, P = .016), myopic refraction (OR = 4.32, P < .0005), and higher intake of vitamin B6 (OR = 2.61, P = .001) to be associated with PVD after controlling for age. In the subgroup analysis of women, menopause (OR = 18.2, P < .0005), myopic refraction (OR = 3.42, P = .01), and higher intake of vitamin B6 (OR = 3.92, P = .005) were associated with PVD. Specifically, there was a significant association between vitamin B6 and PVD amongst premenopausal women but not amongst postmenopausal women. CONCLUSIONS: An association between PVD and menopause has not been documented previously. We suspect that high estrogen levels seen in premenopausal women may be protective against PVD and that hormonal changes associated with menopause may lead to changes in the vitreous, predisposing to PVD. Higher levels of intake of vitamin B6 were also associated with the development of PVD in premenopausal women possibly through an anti-estrogen effect. These findings should be investigated further with prospective studies.

Case-Control Studies↗

PubMed2006

Update on utilities and cost-utility analyses.

PURPOSE OF REVIEW: The purpose of this review is to summarize the recent and noteworthy utility studies and cost-utility analyses in the area of retina/vitreous during the period January 2004 to January 2006. RECENT FINDINGS: This review considers the cost-effectiveness of treatments for wet age-related macular degeneration, dry age-related macular degeneration, telemedicine in diabetic retinopathy, and utilities and patients with age-related macular degeneration and diabetic retinopathy. SUMMARY: Utilities are being used increasingly to measure health-related quality of life. Cost-utility analyses are becoming more readily available for comparing the incremental cost-effectiveness of different ophthalmic interventions.

Cost-Benefit Analysis↗

PubMed2005

Comparison of photodynamic therapy and transpupillary thermotherapy for subfoveal choroidal neovascularization due to age-related macular degeneration.

BACKGROUND: The purpose of this study was to compare photodynamic therapy (PDT) against subthreshold transpupillary thermotherapy (TTT) with a diode laser for subfoveal choroidal neovascularization secondary to age-related macular degeneration (AMD). METHODS: Patients with subfoveal choroidal neovascularization secondary to AMD were offered PDT as an initial intervention. If they declined PDT, then TTT was offered. RESULTS: We evaluated and followed 115 consecutive patients for an average of 1 year. The primary outcome measure was visual acuity, but the interventions were also compared on the basis of lesion size and angiographically determined lesion activity. Baseline comparisons between the 2 treatment groups showed significant differences in pretreatment visual acuity, lesion size, and lesion composition. Univariate analysis of outcomes demonstrated equivalence between the treatment groups in final lesion size, angiographic activity, and visual acuity. Multivariate analysis also demonstrated equivalence between the treatment groups in final visual acuity while controlling for age, pretreatment visual acuity, and lesion category. Predominantly classic lesions were associated with poorer visual outcomes. INTERPRETATION: The PDT and TTT groups were equivalent in terms of all outcome parameters evaluated.

Aged↗

PubMed2002

Quality of life and systemic comorbidities in patients with ophthalmic disease.

AIM: To ascertain the effect of serious systemic comorbidities upon the quality of life of patients with ophthalmic diseases. METHODS: Time tradeoff utility values were obtained in consecutive ophthalmic patients who presented with ocular disease. Multivariate analysis was undertaken to evaluate whether the systemic comorbidities of diabetes mellitus, heart disease, cancer, cerebrovascular accident, and/or renal failure requiring dialysis influenced ocular utility values. RESULTS: Among the 390 patients with ocular diseases studied, 250 had the systemic comorbidities of diabetes mellitus, heart disease, cancer, stroke, and/or renal failure requiring dialysis, while 140 lacked these comorbidities. There was no statistically significant difference (p = 0.091) between the comorbidity and no comorbidity groups in self assessed quality of life as measured by ocular utility values after taking into account potentially confounding variables. CONCLUSIONS: In patients with ocular disease, ocular utility values related to the visual loss do not appear to be affected by the presence of select, concomitant, serious systemic diseases. Thus, visual loss seems to cause a similar diminution in self assessed quality of life in those who do and do not have serious associated systemic comorbidities. This information has important implications for the calculation of cost effective analyses.

Adult↗

PubMedDate not supplied

The influence of prevalence and policy on the likelihood that a physician will offer HIV screening in pregnancy.

OBJECTIVE: To determine the extent to which provincial recommendations, reported regional prevalence rates and perceived local prevalence rates of HIV in pregnancy influence a physician's decision to routinely offer prenatal screening for HIV. DESIGN AND METHODS: A random sample of 5,052 family physicians and obstetricians were surveyed by mail. Logistic regression was used to explore the relationships among the variables of interest. RESULTS: The response rate was 61%. Of these, 69.2% provided prenatal care and were included in the analysis. Physicians were more likely to routinely offer HIV testing if they practiced in provinces with recommendations that supported the universal offer of a test (O.R. = 5.80), independent of living in a region with an estimated prevalence rate exceeding 5/10,000 (O.R. = 1.76), or the perception that the infection rate in their practice justified universal counselling of pregnant women (O.R. = 10.41). CONCLUSIONS: Provincial recommendations supporting universal HIV testing in pregnancy are reflected in physician practice.

AIDS Serodiagnosis↗