Retinoblastoma (RB) is a common intraocular cancer in pediatric patients worldwide, and screening is routinely performed throughout the first few years of life. The diagnosis is often made clinically; however, the diagnosis can be delayed due to undetectable leukocoria because of small tumor size at the time of examination, missed appointments, non-compliance with eye examinations, or failure to perform the exam.As mobile devices continue to gain in both popularity and functionality, their use via applications and smartphone attachments for ocular examination introduces a new avenue for screening, detection, and staging of RB both inside and outside the clinical setting. Currently, research regarding mobile device use is still in its infancy, and further research is required to determine whether mobile devices could play a significant role in assisting with the diagnosis of RB.The purpose of this systematic review was to determine whether the existing literature supports the use of mobile devices by healthcare providers, specifically ophthalmologists and non-ophthalmologists, as well as by parents for the early detection of RB. A comprehensive literature search was conducted via PubMed, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Web of Science with a total of 10 studies included in the final analysis.
Introduction: The association between restless leg syndrome (RLS) and CV outcomes remains controversial in the general population, and the impact of RLS among patients with coronary artery disease (CAD) is unknown. Hypothesis: We examined our hypothesis that RLS symptoms would be associated with incident adverse CV outcomes in patients with CAD. Methods: We inquired about the presence and frequency of RLS symptoms in 3,176 patients enrolled in the Emory Cardiovascular Biobank (mean age 64, 62% male, 23% Black, and 75% with obstructive CAD), who were prospectively followed for death, myocardial infarction (MI), revascularization, and hospitalization for heart failure (HF). Multivariate Cox proportional hazard models were used to examine the association between RLS symptoms and adverse outcomes after adjustment for demographic and clinical risk factors. Results: Of the total, 914 (28.8%) and 482 (15.2%) patients reported mild (rare or sometimes) and moderate/severe (often to almost always) symptoms of RLS, respectively. Female sex (Odds ratio [OR] 2.11, P<0.001), higher body mass index (OR 1.12 per 5kg/m2, P=0.007), diabetes (OR 1.43, P=0.003), and beta blocker use (OR 1.35, P=0.013) were independently associated with moderate-severe symptoms of RLS compared to no symptoms. During a median 3.2-year follow-up, 991 patients suffered at least1 adverse event. Those with moderate/severe symptoms had significantly higher adjusted risk of death/MI (Hazard ratio [HR] 1.30 [1.02 - 1.66]), death/MI/revascularization (HR 1.22 [1.02 - 1.45]), and death/MI/revascularization/hospitalization for HF (HR 1.23 [1.04 - 1.45]). Those with mild symptoms had similar risks to those with no symptoms. Conclusions: Among patients undergoing cardiac catheterization, moderate or severe symptoms of RLS are associated with significantly higher risk of adverse CV outcomes, independent of traditional risk factors. This is the first study to demonstrate an independent adverse impact of RLS symptoms in CAD patients.
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