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Vision Screening in the Pediatrician’s Office

Open Journal of Ophthalmology 2012年第2期2卷 9-13页

作者： Natario L. Couser Fatema Q. Esmail amy k. hutchinson The Department of Ophthalmology Emory University School of Medicine Atlanta USA.

Objective: To assess current practices, attitudes, and perceived barriers toward pediatric vision screening. Patients and Methods: A link.to a 9-question survey was electronically distributed to a national sample of 6000 pediatricians through Medical Mark.ting Services Inc. Data were collected using Survey Monk.y. Results: Email open rate was 11%;37% of those who opened the email responded (225 respondents). Over ninety percent of respondents perform some type of vision screening at least yearly, although age at which screening began varied, with two thirds of respondents instituting formal vision screening after three years. Fifty eight percent of respondents were either extremely unsatisfied, unsatisfied or only somewhat satisfied with their current screening method. Preferred methods of screening and confidence of pediatricians in their ability to detect pathology varied for children under versus over age three. The least frequently used methods for all age groups were autorefraction and photoscreening. The most commonly reported barriers to screening were inadequate training (48%), time required for exam (42%), and inadequate reimbursement (32%). Conclusions: Perceived barriers to vision screening in the pediatrician office have been previously identified, and photoscreening and autorefraction have been identified as a possible means to circumvent them. In spite of the addition of new procedural codes, pediatricians continue to report similar barriers to screening.

关键词： Pediatric Vision Screening Barriers Reimbursement Pediatricians Photoscreening Autorefraction U.S. Preventative Services Task Force CPT 99174

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Non-steroidal anti-inflammatory drugs and statins in relation to colorectal cancer risk

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World Journal of Gastroenterology 2009年第19期15卷 2336-2339页

作者： Mazyar Shadman Polly A Newcomb John M Hampton k.ren J Wernli amy Trentham-Dietz Cancer Prevention Program Fred Hutchinson Cancer Research CenterSeattle 98109United States Department of Epidemiology University of WashingtonSeattle 98195United States Polly A Newcomb University of Wisconsin Paul PCarbone Comprehensive Cancer CenterMadison 53726United States

AIM： To investigate the association between individual or combined use of non-steroidal anti-inflammatory drugs （NSAIDs） or statins and colorectal cancer ***： In a population-based case-control study in women, we examined the association between NSAIDs and statin use and the risk.of colorectal cancers. We further investigated whether the use of statins modifies the protective effect of NSAIDs. Female cases （n = 669）of colorectal cancer aged 50-74 years were identified from a storewide registry in Wisconsin during 1999-2001. Community control women （n = 1375） were randomly selected from lists of licensed drivers and Medicare beneficiaries. Medication use and risk.factor information were gathered during a structured telephone interview. A multivariable logistic regression model was used to calculate odds ratio （OR） and 95% confidence interval （CI）.RESULTS： Overall, NSAIDs users had a 30% reduction in risk.of colorectal cancer （95% CI： 0.56-0.88）. Statin use was not associated with colorectal cancer risk.（OR = 1.17, 95% CI： 0.74-1.85）, regardless of structural type （lipophilic or hydrophilic）, duration of use, or recency. There was no evidence of an interaction between NSAIDs and statins and colorectal cancer risk.（P-interaction = 0.28）.CONCLUSION： Although our results confirm the inverse association between NSAIDs use and colorectal cancer risk. they do not support a risk.reduction in statin users, or an interaction effect of combined NSAIDs and statin use.

关键词： Non-steroidal anti-inflammatory drugs Statin Colorectal cancer Cancer prevention Chemoprevention

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Progression of Platelet Counts in Treatment Naïve HIV/HCV Co-Infection

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World Journal of AIDS 2013年第1期3卷 36-40页

作者： Jonathan E. Schelfhout Danijela A. Stojanovic amy Houtchens Heidi M. Crane Edward R. Cachay Elizabeth R. Brown Sonia M. Napravnik.Mari M. k.tahata Michael S. Saag Peter W. Hunt Teresa L. k.uf Joseph A. C. Delaney Department of Epidemiology University of Washington Seattle WA Department of Medicine University of Alabama at Birmingham Birmingham USA Department of Medicine University of California at San Diego San Diego USA Department of Medicine University of California at San Francisco San Francisco USA Department of Medicine University of North Carolina Chapel Hill USA Division of Allergy & Infectious Disease Department of Medicine University of Washington Seattle USA Food and Drug Administration Silver Spring USA Vaccine and Infectious Disease and Public Health Sciences Divisions Fred Hutchinson Cancer Research Center Seattle USA

Back.round: Previous research has suggested an association between infection with hepatitis C virus (HCV) or with human immunodeficiency virus (HIV) and low platelet counts. This study estimates platelet count changes over time in HIV/HCV co-infected participants and compares them with the changes in platelet count among HIV mono-infected participants to test if HIV/HCV co-infection is associated with lower platelet counts. Methods: This retrospective cohort study included all HIV treatment naive patients from four sites in the Centers for AIDS Research Network.of Integrated Clinical Systems (CNICS) cohort with platelet count measurements between 2002 and 2009. We conducted a mixed effects linear regression modeling the mean change in platelet count per year while adjusting for age, sex, race, baseline CD4 cell count, and site. Index date was the first platelet count after 2002, and participants were censored upon initiation of treatment for HIV or HCV. Results: There were 929 HIV/HCV co-infected and 3558 HIV mono-infected participants with a mean follow-up time of 1.2 years. HIV/HCV co-infected participants had on average a slighter lower platelet count at baseline (234,040 vs. 242,780/μL;p-value = 0.004), and a more rapid mean reduction per year (7230 vs. 3580/μL;p-value 0.001) after adjusting for age, sex, baseline CD4 count. Conclusions: In treatment naive participants, HIV/HCV co-infection is associated with a more rapid decline in platelet count compared with HIV mono-infection.

关键词： HCV HIV AIDS Co-Infection Platelet Count Thrombocytopenia

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