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Biomedical subjects

J Maino

Publications and source records attributed to J Maino.

6 recordsLinked to original sources

Veterans Affairs Multicenter Low Vision Enhancement System (LVES) study: clinical results. Report 1: effects of manual-focus LVES on visual acuity and contrast sensitivity.

PURPOSE: The Department of Veterans Affairs LVES Study is a multicenter study to determine the effectiveness of the Low Vision Enhancement System (LVES) as a visual rehabilitation device. The purpose of this study was to explore the efficacy of the Beta 1 manual-focus LVES for improving visual acuity and contrast sensitivity. METHODS: Patients whose visual acuity was 20/80 or worse in the better eye from any disease, who did not have significant visual field loss, who had previous low vision experience and were capable of working with the LVES were enrolled in a comprehensive prospective multicenter clinical evaluation. Initially, corrected spectacle visual acuities were measured using a standardized ETDRS chart. Contrast sensitivities were also measured with spectacle correction using a standardized Peli-Robson chart. These results were then compared to the acuities and contrast sensitivity obtained with the LVES at optimal magnification. Also, visual acuities were measured using an Eschenbach 3x spectacle-mounted binocular telescope, then compared to the acuities obtained using the LVES set at the lowest magnification (3x). RESULTS: All patients who completed the study demonstrated an improvement in visual acuity, with a median improvement of six lines of Snellen equivalent acuity using the LVES. Improvement in visual acuity was the same in both ARMD and non-ARMD causes of vision loss. Mean contrast sensitivity improved in 52 of 58 patients tested, with a mean improvement of 0.49 log units. CONCLUSION: The LVES significantly improves both visual acuity and contrast sensitivity in visually impaired patients who fall within the study criteria. Up to 10-fold improvement in visual acuity and up to 1.80 log units improvement in contrast sensitivity were noted in the study group when the LVES was used.

Adult↗

National survey of the impact of low vision device use among veterans.

BACKGROUND: This report presents the results of a 2-year study of veterans' use of low vision devices (LVDs) which were prescribed and dispensed through he Blind Rehabilitation Centers (BRCs) and Visual Impairment Centers to Optimize Remaining Sight (VICTORS) of the Department of Veterans Affairs. METHODS: Two-hundred veterans using 740 LVDs were surveyed by telephone 12 to 24 months after the prescription/dispensing of the devices. Reliability (test-retest) and validity (content, criterion-related, and construct) were established for the survey. Primary analysis of the data was accomplished through tabular presentations. Factor analyses were used to describe prescription and use patterns. RESULTS: Most (85.4%) of the devices were still in use. Having a helper in the home was a demographic variable related to continued use. Neither age, acuity, nor etiology were related to continued use. Strong prescription and use patterns emerged. Most veterans reported receiving > 20 h of training and > 20 h of practice in the use of their LVDs. CONCLUSIONS: Most veterans who receive LVDs through the service delivery system of the Department of Veterans Affairs appear to use them for a wide variety of daily tasks and reported that they obtain a great deal of benefit from their use.

Adult↗

Veterans' use of low vision devices for reading.

BACKGROUND: This report presents the results of a 2-year study of veterans' use of low vision devices (LVDs) which were prescribed and dispensed through the Blind Rehabilitation Centers (BRCs) and Visual Impairment Centers to Optimize Remaining Sight (VICTORS) of the Department of Veterans Affairs. METHODS: Two-hundred veterans using 740 LVDs were surveyed by telephone 12 to 24 months after the prescription/dispensing of the devices. Reliability (test-retest) and validity (content, criterion-related, and construct) were established for the survey. Primary analysis of the data was accomplished through tabular presentations. Because most devices were used for reading, an exploratory data analysis was completed to further investigate successful use of LVDs for this task. Relationships of 21 variables with a definition of highly successful use, use and nonuse of LVDs for reading were evaluated. RESULTS: Only visual acuity provided a statistically significant predictor of use of LVDs for reading. LVDs in the lowest visual acuity grouping tend to be used either highly successfully, or fall into the nonuse category. The highly successful LVDs are primarily video magnifiers; the nonused LVDs tended to be spectacle magnifiers. CONCLUSIONS: This population is using devices extensively for reading, reporting frequencies of use of several times per day.

Health Surveys↗

Primary and secondary iris cysts.

Primary cysts of the iris usually arise from the pigment epithelial layers and are almost always benign, stationary lesions which require no treatment. Those cysts which are secondary to such agents as trauma or inflammation are, however, characterized by progressive enlargement and visual complications. The major clinical significance of iris cysts lies in their similarity to iris melanomas. Cysts should be monitored for enlargement and/or other complications such as inflammation or secondary glaucoma.

Adult↗

Family participation during resuscitation: an option.

We began to question the fairness of a policy to exclude close family members from the treatment room during attempted resuscitation of cardiac arrest victims in 1982 after 13 of 18 surviving relatives (72%) who were surveyed about their experiences during the attempted resuscitation of a family member responded that they would have liked to have been present during the resuscitation. We report the results of a program instituted at that time that allowed selected family members to be present during resuscitation efforts. Family members were asked by a chaplain or nurse if they wished to be present in the resuscitation room, and those accepting were accompanied by a supporting emergency staff member who explained the milieu of the code room. None of the participants interfered with resuscitation efforts. Seventy persons who participated were later contacted by one of the chaplains and asked to complete a survey form. Forty-four of 47 respondents (94%) who had been present during resuscitation believed that they would participate again. Thirty-six (76%) thought that adjustment to the death or grieving was facilitated by their witnessing the resuscitation; 30 (64%) felt that their presence was beneficial to the dying family member. We conclude that lay person may wish to be with family members who may be dying even though resuscitation efforts are being made, and that it is reasonable to inquire about this wish. This experience has assisted the grieving process for many and has not interrupted or adversely affected medical efforts at resuscitation.

Adaptation, Psychological↗

Community hospital administration of intravenous tissue plasminogen activator in acute myocardial infarction: improved timing, thrombolytic efficacy and ventricular function.

As an investigational fibrinolytic agent for acute myocardial infarction, intravenous recombinant tissue-type plasminogen activator (rt-PA) has been administered primarily in tertiary care and university centers. To determine the value of early initiation of such therapy, two satellite community hospital emergency rooms were established for use of rt-PA and the experience was compared among 142 consecutive patients who were transferred to a regional center for acute cardiac catheterization after intravenous rt-PA therapy. In Group I (n = 19), patients received rt-PA after interhospital transport to the regional center, but before cardiac catheterization. In Group II (n = 70), rt-PA therapy was initiated by the helicopter physician and nurse team after their arrival at the local community hospital emergency room. Group III patients (n = 53) had rt-PA administered in the local community hospital by the emergency room physician. Group III patients had earlier initiation of therapy (2.1 +/- 0.8 hours in Group III versus 3.8 +/- 1.2 hours in combined Groups I and II, p less than 0.001) and an increased rate of infarct vessel recanalization on the 90 minute coronary angiogram (81 in Group III versus 67% in combined Groups I and II, p = 0.057). The patients in Group III had a higher acute left ventricular ejection fraction (54 +/- 8% versus 50 +/- 9.5% in combined Groups I and II, p less than 0.01) and a trend toward an increased 7 day ejection fraction (55.5 +/- 9% versus 51.7 +/- 9.5%, respectively, p = 0.08).(ABSTRACT TRUNCATED AT 250 WORDS)

Cardiac Catheterization↗