Neuro-Ophthalmic Sarcoidosis

To report a case serious of neuro-ophthalmic manifestations of sarcoidosis from a predominantly Caucasian Midwest population

Relationship Between Axon Loss and Visual Field Loss in Anterior Ischemic Optic Neuropathy (AION)

In this study the degree of axon loss was correlated with corresponding visual field sensitivity to understand the relationship between structure and function in ischemic optic neuropathy and to assess subclinical axon loss, in areas not associated with visual field loss

Perimacular Ganglion Cell Complex Thinning Detected By Spectral-Domain OCT Useful In Detecting Optic Tract Syndrome

"Unilateral lesions to the optic tract lead to optic nerve atrophy (bow-tie atrophy) and concurrent macular ganglion cell complex (GCC) thickness reduction in a reproducible pattern in both eyes. This is called optic tract syndrome and it is reflected clinically as an incongruous homonymous hemianopia and a contralateral relative afferent pupillary defect (RAPD).

Impact of a videoconferencing educational programme for the management of concurrent disorders on nurses’ competency development and clinical practice: protocol for a convergent mixed methods study

Introduction Extension for Community Healthcare Outcomes (Project ECHO©) is an innovative model for continuing professional development that uses videoconferencing technology to support and train general practitioners remotely. The model has been replicated to a variety of settings and locations for capacity building in healthcare professionals caring for patients with chronic and complex health conditions. Limited research has been conducted so far on the impact of ECHO in the field of concurrent mental health and substance use disorders (ie, concurrent disorders (CDs)). Therefore, this mixed methods study aims to develop a comprehensive understanding of an ECHO programme impact for CD management on nurses’ competency development and clinical practice.Methods and analysis The proposed mixed methods study, based on a convergent parallel design, will be conducted in the province of Quebec, Canada, to collect, analyse and interpret quantitative (QUAN) and qualitative (QUAL) data from a specific ECHO Program on CDs. In the QUAN component, an observational prospective cohort study will be conducted over a 12-month period. All nurses who participated in the programme between 2018 and 2020 and who consent to research will be recruited to collect data on the extent of their learning and practice outcomes at three time points. Alongside the surveys, nurses will be invited to participate in individual semistructured interviews. In-depth QUAL data will be subjected to a thematic analysis and will assist in exploring how and in which conditions nurses developed and mobilised their competencies in clinical practice. A comparison-of-results strategy will be used in the final integration component of the study.Ethics and dissemination This study protocol was approved by the Ethics Committee of the Université de Montréal Hospital Center (#19.295) and the Université de Montréal Ethics Committee (CERSES-20–017 R). We aim to disseminate the findings through international academic conferences, international peer-reviewed journals and professional media

Clinical Heart fAilure Management Program: Changing the practice by partnering primary care and specialists (CHAMP-HF)

Background: While significant gains were made in the management of heart failure (HF), most patients are still diagnosed when they are acutely ill in hospital, often with advanced disease. Earlier diagnosis in the community could lead to improved outcomes. Whether a partnership and an educational program for primary care providers (PCP) increase HF awareness and management is unknown. Methods: We conducted an observational study between March 2019 and June 2020 during which HF specialists gave monthly HF conferences to PCP. Using a pre-post design, medical charts and administrative databases were reviewed and a questionnaire was completed by participating PCP. Primary and secondary endpoints included: 1) the number of patients diagnosed with HF, 2) implementation of GDMT for patients with HFrEF; 3) PCPs’ experience and confidence. Results: Six PCP agreed to participate. Amongst the 11,909 patients of the clinic, 70 (0.59 %) patients met the criteria for HF. This number increased by 28.6 % (n = 90) after intervention. Increased use of GDMT for HFrEF patients at baseline (n = 35) was observed for all class of agents, with doubling of patients on triple therapies, from 8 (22.9 %) to 16 (45.7 %), p = 0.0047. Self-confidence on HF management was low (1, 16.7 %) but increased after the educational intervention of physicians (3, 50 %). Conclusion: An educational and collaborative approach between HF specialists and community PCP increased the number of new HF cases diagnosed, enhanced implementation of GDMT in patients with HFrEF and increase PCPs’ confidence in treating HF, despite being conducted during the COVID-19 pandemic