Dissertations / Theses on the topic 'Ophthalmic system'

Telefonrådgivning är en vanlig vårdform. I en alltmer medicinskt och tekniskt utvecklad ögonsjukvård efterfrågas ögonsjuksköterskornas omvårdnadskompetens av både patienter, anhöriga och kollegor inom andra delar av sjukvården. Syftet med studien var att undersöka ögonsjuksköterskors upplevelser av att använda sin specifika omvårdnadskunskap vid telefonrådgivning inom ögonsjukvård. Studien genomfördes med en kvalitativ metod och data samlades in genom semistrukturerade intervjuer. Materialet analyserades med kvalitativ innehållsanalys. Resultatet visade att ögonsjuksköterskorna upplevde arbetet som utvecklande och utmanande. De såg sig själva som en lots i vården med en stor rådgivande funktion relaterat till sin specifika kunskap. De beskrev också en del svårigheter med att triagera via telefon. De önskade bättre bedömningsunderlag men var dock trygga med sina bedömningar och någon rädsla för anmälningar till tillsynsmyndighet framkom inte. De uttryckte även ett behov av utbildning inom samtalsmetodik. Ögonsköterskorna saknade tid för kollegiala reflektioner för att utveckla sin professionella hållning i arbetet med telefonrådgivningen
Telephone counseling is a common form of care. In an increasing medical and technical development in ophthalmological care is ophthalmic nurses skills demanded by both patients, relatives and colleagues in other areas of health care. The purpose of this study was to examine the eye nurses experiences of telephone counseling in ophthalmology. The study was conducted using a qualitative approach and data were collected through semi-structured interview. The material was analyzed using qualitative content analysis. The results showed that eye nurses were confident and proud of their professional role. They experienced the work as fun, stimulating and challenging. They saw themselves as a pilot in the care of a large advisory role related to their specific knowledge. They also described some difficulties in triagera by phone. They wanted better assessment documentation but was confident in their assessments and any fear of notifications to the regulator were not revealed. They also expressed a need for training in counseling skills. Ophthalmic nurses lacked the time for collegial reflection to develop their professional attitude in the work of telephone counseling.

Darbo tikslas – sumodeliuoti skystą oftalmologinę hidrofilinę sistemą su numatytais fizikocheminiais rodikliais ir įvertinti modelinės medžiagos – natrio diklofenako atpalaidavimą biofarmaciniu metodu in vitro.
Objective of work: to design liquid hydrophilic ophthalmic system with provided physicochemical characteristics and determine the release of the model material - sodium diclofenac in vitro.

Telefonrådgivning är en av arbetsuppgifterna för ögonsjuksköterskor, men studier om telefonrådgivning inom ögonsjukvård är begränsat. Syftet var att beskriva ögonsjuksköterskors upplevelser av användandet av beslutsstöd vid telefonrådgivning. Metoden var kvalitativ beskrivande. Sex ögonsjuksköterskor vid tre olika ögonkliniker intervjuades. Data analyserades enligt kvalitativ innehållsanalys. Resultatet gav huvudkategorierna kunskapskälla vid behov, stöd i yrkesrollen, brister i beslutsstödet och god vårdkvalitet ur ett patientperspektiv. Ögonsjuksköterskorna var positiva till användandet av beslutsstöd vid oerfarenhet av arbetsuppgiften samt vid sällan förekommande och komplexa situationer. Användandet av beslutsstöd upplevdes underlätta prioritering och samordning av vårdinsatser vilket upplevdes leda till god vårdkvalitet ur ett patientperspektiv och en känsla av trygghet. Beslutsstödet underlättade kommunikationen med andra vårdenheter och vårdsökande. Det upplevdes inte täcka alla situationer utan uttrycktes behövdes utvecklas och uppdateras kontinuerligt. Aktivt lyssnande och tänkande i kombination av erfarenhet och kunskap ansågs vara viktiga komponenter vid telefonrådgivning. Vidareutveckling och förbättring av de beslutsstöd som används idag är av betydelse.
Telephone counseling is one of the tasks in ophthalmic nursing and research within this area was found inadequate. The aim was to describe the ophthalmic nurses’ experiences of using a decision making system in when counseling. The method was a descriptive qualitative de sign. Six ophthalmic nurses at three different eye clinics were interviewed. The data were analyzed according to qualitative content analysis. The result was four categories: a source of knowledge source if needed, supportive to the professional role, deficiencies in decision system and good quality of care from a patient perspective. Ophthalmic nurses were positive using a decision making system if inexperienced and in infrequent and complex situations. The use of decision making system facilitated the prioritization and coordination of the care taken, high quality of care from a patient perspective and a sense of security. Decision making system facilitated communication with other health care providers and patients. The system though was not useful in every situation and there was a need of a continuous development and update. Active listening and thinking in the combination of experience and knowledge were considered to be important components in the telephone counseling. Further development of the system in use today is needed.

Thesis (Ph. D.)--School of Pharmacy. University of Missouri--Kansas City, 2005.
"A dissertation in pharmaceutical sciences and pharmacology." Advisor: Ashim K. Mitra. Typescript. Vita. Title from "catalog record" of the print edition Description based on contents viewed June 26, 2006. Includes bibliographical references (leaves 174-192). Online version of the print edition.

In this study, fluorescein angiograms of the ocular fundus have been digitised to enable them to be processed and analysed by computer. A fully automated technique for counting microaneurysms (MA) in these images was developed with a view to producing an objective, accurate and highly repeatable way of quantifying these lesions. Prior to any other image processing, a number of pre-processing stages were applied in order to compensate for non-uniformaties and to remove the background fluorescence component present in all the images. Matched filters modelled on two-dimensional Gaussian distributions were employed to detect MA in the 'shade-corrected' images. A binary image representation of the vascular network was constructed. This 'vessel mask', used in conjunction with the original match-filtered images, enabled MA to be detected by grey-level thresholding the filtered images. The resulting binary objects could then be counted by the computer as MA. The automated technique was assessed by comparing the computer's results for six fluorescein angiograms with MA counts obtained by ophthalmologists analysing both analogue and digital images. The performance of both man and machine were judged with respect to 'gold standards' compiled from prints of the original negatives. The best results were obtained by the clinicians analysing the analogue prints, although they differed greatly in their ability to detect microaneurysms. The computer performed better than the clinicians when they were counting MA in the digital images and produced highly repeatable results. To improve the performance of the automated technique, images were captured at approximately four times the previous spatial resolution and a smaller area of each image was analysed. Additionally, more complex image-processing techniques were employed to increase the accuracy of the computer analysis. Although the performance of the automated technique was improved, the computer results only matched those of the clinicians' analogue analyses for two of the images.

Two specific drug-delivery applications were sought in this work using polyamidoamine (PAMAM) dendrimers. One drug-delivery system used a novel dendrimer hydrogel (DH) for sustained delivery of anti-glaucoma drugs. In this work, PAMAM G3.0 dendrimers were covalently bonded with poly(ethylene glycol) (PEG­12000) molecules which were subsequently acrylated, resulting in photocurable DH conjugates. For pharmacological studies, DH were loaded with a solution of intraocular pressure lowering drugs, brimonidine and timolol maleate, and were characterized for in vitro release and ex vivo transport and uptake. DH formulations were shown to increase the loading of drug molecules, increase transcorneal drug delivery, and exhibit sustained-delivery of drug molecules. A second drug-delivery system, utilizing cell-surface engineering, intended to increase the targeting ability of highly toxic anti-cancer drugs to curtail systemic effects. In particular, Qdots and 5-(aminoacetamido) fluorescein-labeled polyamidoamine dendrimer G4.5, both of which were coated with amine-derivatized polyethylene glycol, were immobilized to the sodium periodate-treated surface of RAW264.7 macrophages through a transient Schiff base linkage. Further, a reducing agent sodium cyanoborohydride was applied to reduce Schiff bases to stable secondary amine linkages. The distribution of nanoparticles on the cell surface was observed by fluorescence microscopy and was found to be dependent on the stability of the linkages tethering nanoparticles to the cell surface.

In our work we have studied the ultrasonic imaging systems and their use in ophthalmology, especially with the device Nidek 4000. We described ophthalmological examination methods. In addition, we are using the simulation program Field II. It simulated eye phantom and created his B-scan and biometry, where we compared the effects of different central frequency ultrasonic probes and different speeds of sound in the resulting values. We also created phantoms using agarose gel and materials of different properties. On phantoms, we studied the effect of the velocity of ultrasound in measurement results, effect of the concentration of the agarose gel to the velocity of sound. And we created phantoms simulating the human eye. Measurement protocol was created for use in teaching.

Purpose: To analyze the patterns of dopplervelocimetry of the ophthalmic artery in pregnant and no-pregnant patients with systemic lupus erythematosus (SLE) without renal disorder flares, and to compare the Doppler indexes of normal pregnant women. Methods: an observational study was carried out through Doppler indexes evaluation of the ophthalmic artery of 20 normal pregnant women, 10 pregnant women with SLE, and 17 non-pregnant women with SLE. The variables analyzed were: pusatility and resitance indexes (PI, RI), peaks systolic velocity, and the enddiastolic flow velocity (PSV, EDV) and peak ratio (PR). For the comparison of the Doppler indices the test of variance (ANOVA) and the post-analysis test of Tukey were used. The Pearson linear correlation analysis was performed to study the values changes at the time of the disease. The level of significance determined in the study was 5%. Result: there were no significant differences between the two SLE groups, concerning the Doppler values, except for PSV (p=0,026). Nevertheless, the means of RI, PI, EDV and PR of the ophthalmic arteries were compared, between the groups of normal pregnant women and pregnant women with SLE, significant differences were observed (p=0,01; p=0,02; p=0,05; p=0,04) The RI and PI, in both groups of women with ESL, were lower them the indexes of normal pregnants. But PR and EDF were higher in women with ESL whem compared with normal pregnants. There were no signiticant correlation between time of lupus and Doppler indexes PI, RI, SVF, EDV, PR, for pregnant groups (r=0,509, r=0,462;r=0,738;r=0,422) and non-pregnants (r=0,840; r=0,005; r=0,063; r=0,284; r=0,323). Conclusions: There was ophthalmic artery impedance flow reduction in both groups of patients with SLE compared to normal pregnants. Concerning the Doppler variables of the ophthalmic arteries, there were no significant differences between the groups of pregnant and non-pregnant women with SLE. No association of time of disease and ophthalmic artery Doppler indexes , in both pregnants groups, was found.
Objetivo: Analisar os padrões dopplervelocimétricos da artéria oftálmica em gestantes portadoras de LES, sem doença renal em atividade, em relação às mulheres não-grávidas com LES sem atividade de doença renal e grávidas normais. Determinar a associação entre o tempo de evolução do LES e os padrões dopplervelocimétricos da artéria oftálmica de mulheres gestantes e não-grávidas portadoras de LES sem atividade de doença renal. Métodos: Estudo observacional que analisou o padrão Doppler da artéria oftálmica de 20 grávidas normais, 10 gestantes com LES e 17 mulheres não-grávidas com LES. As variáveis analisadas foram os índices de pulsatilidade e resistência (IP, IR), os picos de velocidade sistólico e diastólica (PVS, PVD) e a razão entre picos de velocidade (RPV). Para comparação dos índices Doppler utilizou-se o teste de variância (ANOVA) e prova pós-análise de Tukey. Para avaliar a correlação entre o tempo de evolução de LES no grupo de gestantes e não-grávidas com as variáveis dopplervelocimétricos da artéria oftálmica utilizou-se o Coeficiente de Correlação Linear de Pearson. Adotouse o intervalo de confiança de 95% (p< 0,05) para os testes estatísticos. Resultados: Não houve diferenças significativas entre as médias dos índices Doppler entre os dois grupos de pacientes com LES, exceto pelo PVS (p=0,026). Porém quando comparadas às médias do IR, IP, VDF e RPV das artérias oftálmicas entre os grupos de grávidas normais e gestantes com LES observou-se diferenças significativas (p=0,010; p=0,019; p=0,050; p=0,044, respectivamente). Os índices IR e IP, nos dois grupos de mulheres com LES, demonstraram valores inferiores aos encontrados no grupo de grávidas normais. Já a RPV e VDF, nos dois grupos de mulheres com LES, apresentaram valores superiores aos encontrados no grupo de grávidas normais. Não houve correlação significativa entre o tempo de evolução do LES e as variáveis dopplervelocimétricas IP, IR, PVS, VDF, RPV para o grupo de grávidas (r=0,509, r=0,462; r=0,738; r=0,578; r=0,422) e para o grupo de nãográvidas (r=0,840; r=0,005, r=0,063; r=0,284; r=0,323, respectivamente) Conclusões: Houve queda da impedância vascular da artéria oftálmica nos dois grupos de pacientes com LES em relação às gestantes normais. Não houve diferença estatística significativa entre os índices Doppler da artéria oftálmica nos grupos de gestantes com LES e não-grávidas com LES. Não houve associação entre o tempo de doença e os índices Doppler nos dois grupos de pacientes avaliadas.
Mestre em Ciências da Saúde

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior
This doctoral thesis involved the study of ocular and periocular diseases affecting domestic animals, and included one manuscript about lesions of surgical pathology and one manuscript about hyphema in dogs and cats submitted to necropsy. In the first part, 33,075 reports of hystopathological exams performed in a veterinary pathology diagnostic laboratory in the Central Region of the State of Rio Grande do Sul, Brazil, over 50 years. From the total amount, 540 (1.6%) concerned ocular and periocular lesions. For various reasons ninety specimens were excluded from the study, 450 remaining. More than half of all cases consisted of samples from dogs (53.5%), followed by cattle (28.2%), cats (11.1%), horses (5.1%) sheep (1.3%), rabbits (0.4%), and pig (0.2%). The eyelids were the most prevalent (248/450) site of lesions in each of the species studied, followed by third eyelid (73/450), and conjunctiva (27/450). In dogs lesions in sebaceous glands were the most common findings (75/241), followed by melanocytic tumors and nonspecific conjunctivitis. In cattle, anatomical sites affected by ocular and periocular lesions, in decreasing order of frequency, were eyelid, cornea and third eyelid. Squamous cell carcinoma (SCC) alone accounted for 80.3% of all lesions diagnosed in cattle. Neoplasia accounted for most of the lesions diagnosed in cats (39/50 cases); all of these were malignant, and SCC, hemangiosarcoma and fibrosarcoma were the most common types diagnosed. In horses, 19 out of 23 submissions were neoplasms and most were sarcoid (8/23) and SCC (8/23). In sheep, all samples represented SCC of the eyelids (5) and third eyelid (1). For the second manuscript, cases of hyphema in dogs and cats submitted to necropsy were examined. Twenty cases, 14 dogs and six cats of several ages and breeds and of both sexes were included in the study. Hyphema presented as a unilateral (14 cases out of 20) or bilateral (6/20) disorder in dogs and cats and extension of hemorrhage varied from minimal to diffuse. Hyphema was secondary to systemic disease (15/20) or occurred as a primary ocular lesion (5/20) in four dogs and one cat. Primary hyphema was always unilateral. In four of these cases, the cause of hyphema was trauma and remaining case was caused by phacoclastic uveitis in a dog with bilateral hypermature cataract. Various causes of bleeding disorders were found related to secondary hyphema: in decreasing order of frequency, they included vasculitis (8/15), systemic hypertension (5/15), and acquired coagulopathies (2/15).
Esta tese envolveu o estudo de doenças oculares e perioculares de animais domésticos, e incluiu um artigo sobre lesões de patologia cirúrgica e um artigo sobre hifema em cães e gatos submetidos à necropsia. Para o primeiro trabalho, foram examinados 33.075 laudos de exames histopatológicos realizados num laboratório de diagnóstico de patologia veterinária na Região Central do Rio Grande do Sul durante 50 anos. Destes, 540 (1,6%) eram de lesões oculares e perioculares. Por várias razões, 90 espécimes foram excluídos do estudo, restando 450. Mais da metade dos casos correspondiam a espécimes de cães (53,5%), seguidos por bovinos (28,2%), gatos (11,1%), cavalos (5,1%), ovelhas (1,3%), coelhos (0,4%), e porco (0,2%). As pálpebras foram o local mais prevalente (248/450) de ocorrência das lesões em cada uma das espécies, seguidas da terceira pálpebra (73/450) e conjuntiva (27/450). Em cães, as lesões nas glândulas sebáceas consistiram nos achados mais comuns, seguidos dos tumores melanocíticos e de conjuntivites inespecíficas. Em bovinos, os locais anatômicos afetados por lesões perioculares e oculares, em ordem decrescente de frequência, foram pálpebra, córnea e terceira pálpebra. Somente o carcinoma de células escamosas (CCE) perfez 80,3% de todas as lesões diagnosticadas em bovinos. Em gatos, a maioria (39/50 casos) das lesões diagnosticadas era de neoplasia maligna, e CCE hemangiossarcoma e fibrosarcoma foram os diagnósticos mais frequentes. Em equinos 19 de 23 submissões eram neoplasmas e os mais comuns foram sarcoide (8/23) e CCE (8/23). Em ovinos, todas as amostras correspondiam a casos de CCE de pálpebra (5/6) ou terceira pálpebra (1/6). Para o segundo trabalho, casos de hifema em cães e gatos submetidos à necropsia foram examinados. Vintes casos, 14 cães e seis gatos de várias idades e raças e de ambos os sexos foram incluídos no estudo. O hifema teve uma apresentação unilateral (14 casos dos 20) ou bilateral (6/20), e a extensão da hemorragia variou de mínima a difusa. O hifema era secundário à doença sistêmica (15/20) ou ocorreu como lesão ocular primária em cinco dos 20 casos (quatro cães e um gato). O hifema primário foi sempre unilateral; a causa foi traumatismo em quatro desses casos, e o caso restante foi causado por uveíte facoclástica em um cão com catarata hipermadura bilateral. Várias causas de distúrbios hemorrágicos foram encontradas em relação ao hifema secundário: em ordem decrescente de frequência foram: vasculite (8/15), hipertensão sistêmica (5/15) e coagulopatias adquiridas (2/15).

Les technologies utilisant le CO2 supercritique sont considérées comme des alternatives vertes et éco-responsables pour la formulation de médicaments et le traitement de dispositifs médicaux. Ce travail de thèse a pour objectif de développer des dispositifs médicaux ophtalmiques innovants pour prévenir deux complications postopératoires de la chirurgie de la cataracte, l’endophtalmie et l’opacification de la capsule postérieure. Parmi d'autres procédés, l'imprégnation supercritique a été sélectionnée pour incorporer des principes actifs ophtalmiques dans des implants intraoculaires (IOLs) disponibles dans le commerce et largement utilisés pour la chirurgie de la cataracte. Une action ciblée des médicaments avec une libération prolongée directement dans les zones potentiellement affectées peut être atteinte sans nécessiter d'interventions médicales supplémentaires. L’imprégnation supercritique d’IOLs acryliques hydrophobes et souples a été étudiée en faisant varier les conditions opératoires de pression (8 à 25 MPa), de température (308 à 328 K) et de durée (30 à 240 min). L'influence de l'utilisation de l’éthanol comme co-solvant a également été évaluée. La cinétique de relargage du médicament \textit{in vitro} a été suivie pour déterminer les taux d'imprégnation. Afin de rationaliser l’influence des phénomènes concomitants gouvernant l’imprégnation, les comportements thermodynamiques des systèmes impliqués, polymère/ CO2 et médicament/CO2, ont été étudiés. L’implantation des dispositifs médicaux imprégnés dans des sacs capsulaires de donneurs humains ont montré le potentiel clinique de ces implants à libération prolongée innovants
Supercritical CO2 technologies are arisen as green and eco-responsible alternatives for drug formulation and medical device processing. The present PhD work aims to develop innovative ocular therapeutic medical devices to mitigate two post-operative complications of cataract surgery, endophthalmitis and posterior capsule opacification. Among other processes, supercritical impregnation was selected to load commercially available intraocular lenses (IOLs) commonly used in cataract surgery with ophthalmic drug components. A targeted action of drug molecules can be therefore achieved through a sustained release directly at the potential affected zones without requiring subsequent medical interventions. Supercritical impregnation of foldable hydrophobic acrylic IOLs was studied by varying the operating conditions of pressure (8 to 25 MPa), temperature (308 to 328 K) and impregnation duration (30 to 240 min). The influence of using ethanol as a co-solvent was also evaluated. In vitro drug release kinetics were studied and used to determine the impregnation yields. In order to rationalize the influence of the concomitant phenomena governing impregnation, thermodynamic behaviors of the involved systems, polymer/CO2 and drug/CO2 were studied. {Ex vivo} implantation of methotrexate impregnated IOLs on human donor capsular bags shown fibrosis reduction by inhibiting epithelial-mesenchymal transformation highlighting the potential of the innovative sustained-release drug-delivery IOLs to become of clinical relevance

碩士
逢甲大學
視光科技碩士在職學位學程
106
In recent years, artificial intelligence technology has progressed. Currently, there are app or software related ophthalmic dispensing consultation , but it’s too complicated and insufficiency function. The purpose of this study is to use the “The Ophthalmic Dispensing Expert system” to improve the quality speed of ophthalmic dispensing and increase customer satisfaction. Apply the clinical ophthalmic dispensing experience and data of theory to establish database,the Inference Enging offer specific consultation rules. When optometrist encounters problems, he can getthrough “The Ophthalmic Dispensing Expert system” immediately do the dispensing adjustment and correct the problem. So that customers can wear spectacle comfortably and have good vision,The Optometrist use the system will shorten the dispensing time and improve the quality of service. The result and analysis of the test of “The Ophthalmic Dispensing Expert system” , shown that after the use, the degree of satisfaction is 84%, acceptance is 86%, and professional advice is 93%. Therefore, when an on-site optometrist encounters dispensing problems, he can quickly get professional advice through “The Ophthalmic Dispensing Expert system” .

Spectral‐domain optical‐coherence tomography (SDOCT) has recently emerged as a powerful new tool for noninvasive human retinal imaging. I have developed a low‐cost, high resolution real‐time Spectral Domain Optical Coherence Tomography (SDOCT) system optimized for rapid 3D imaging of the human retina in vivo. Then functional retinal OCT imaging such as polarization sensitive OCT (PSOCT) and Doppler OCT were also developed based on phase technique. Unique phase unwrapping method in retina is described to extract the total reflectivity, accumulative retardance and fast axis orientation of the retinal nerve fiber layer (RNFL). The polarization scrambling layer of the retinal pigment epithelium was segmented by employing single camera sequential scan bsed PSOCT. As an extension, synthetic wavelength method will be also introduced for phase unwrapping in cell imaging. Finally I present an algorithm for 3D refraction correction based on a vector representation which accounts for refraction of CT light in the cornea. Following 3D refraction correction of volumetric corneal datasets, we can estimate the corneal optical power, thickness and the individual wavefront aberrations of the epithelial and the refraction‐corrected endothelial surfaces by using Zernike spectrum analysis.

Dissertation

碩士
逢甲大學
光電能源與視覺科技碩士在職專班
104
We present the spectra measurement analysis and optical coating design of anti-UV and anti-blue light ophthalmic lens by using the Macleod optical thin film design software. Two design cases of (MgF2 /TiO2)xMgF2 and (SiO2/Ta2O5)xSiO2 multilayer coatings are compared with commercial anti-Blue light lenses. The multilayer structures use a non-quarter wavelength design with 15-layer and 23-layer film stacks. The results show that the 23-layer design of (MgF2/TiO2)11MgF2 multilayer can meet the market requirement for anti-UV bandwidth. For the anti-blue light measurement system, the spectral response region of the photo detector in the 320 nm to 1100 nm, that is visible to near infrared region. The measurement system composed by three units, it consists of a transmitting circuit, a receiving circuit and a signal processing circuit. The proposed system can measure the wavelength range of 400 nm ~ 700nm, the working voltage of 5V. After completion of the system development, the wavelength of 470 nm blue-light passing through the anti-blue light ophthalmic lens was used to measure the transmittance to verify the anti-blue light ophthalmic lens performance.

碩士
元智大學
工業工程與管理學系
105
In the department of ophthalmology, a patient might be asked to go through several examinations in a single visit. These examinations are critical components in the diagnosis process. Doctors at the department of ophthalmology relay on the examination reports to investigate the conditions of a patient. Although those examinations can be conduct within several minutes, it is still time and resource consuming to dynamically schedule the incoming patient to destined examination rooms. The patient’s examination room scheduling has a set of distinct constrains, such as some examinations must be done in a specific sequence. All those constrains increase the total waiting time for the patients, and decrease the patient’s satisfaction. In response, We propose a new scheduling scheduling system, the shunt treatment people, according to the needs of patients scheduled check. The system consists of two sequential stages of scheduling. Firstly, the multi-objective mixed integer programming is established for the patients who need to be checked, and the fuzziness of the assignment decision is taken into account, and the multi-objective fuzzy relation is used to solve the assignment benefit. In the second step, we adopt the dynamic Hungarian method to determine the task. The flow time and waiting time for the examination room scheduling measure index, and in the numerical study, we will schedule commonly used dispatching rules of longtest process time, earliest due date, shortest process time, and the design of the aversion coefficient and the scheduling objective results. Therefore, this study was designed to assist the first line medical staff automated scheduling system in order to shorten patient waiting time, optimize the examination order, and improve the overall effectiveness of the Ophthalmology Department.

Tese de mestrado, Ciências Biofarmacêuticas, Universidade de Lisboa, Faculdade de Farmácia, 2017
Bacterial keratitis is an infectious disease of the cornea that is characterised by inflammation. The common pathogens associated with this disease include Staphylococcus aureus, coagulase-negative Staphylococcus, Pseudomonas aeruginosa, Streptococcus pneumonia and Serratia species, causing 90% of the bacterial keratitis cases. Currently, treatment of bacterial infections and inflammation in the eye has the problem of anatomic barriers and the delicate nature of the eye. Local drug applied to the eye represents a non-invasive, safe and less painful solution than surgery, laser treatments or eye injections. Ceftazidime is a third generation cephalosporin antibiotic which is effective mainly against pathogens that are usually responsible for ophthalmological infections. Ceftazidime offers a good coverage against Pseudomonas aeruginosa as well as resistance to several types of beta lactamases. The aim of the present work was to prepare a mucoadhesive nanoparticle eye drop formulation containing ceftazidime to treat eye infections. The first step for the development of the eye drop formulation was to prepare a vehicle for nanoparticles. Two different polymers were selected: carboxymethyl cellulose and hydroxypropylmethyl cellulose, both in low and high viscosity. The selection was based in studies of viscosity, zeta potential and interaction with the nanoparticles. After the tests, the work continued with hydroxypropylmethyl cellulose. The development of mucoadhesive chitosan-nanoparticles are proposed as effective delivery systems for ceftazidime through ocular epithelium, taking advantage of the favourable biological properties of hyaluronic acid and chitosan to prolong precorneal residence time of the antibiotic, enhancing drug accumulation and permeation. Nanoparticles were prepared by ionotropic gelation between sodium tripolyphosphate and chitosan with the objective to encapsulate ceftazidime. The formulations were characterized in terms of pH, osmolality, viscosity, zeta potential, particle size distribution and encapsulation efficiency. In addition, the in vitro release and permeation studies were performed and the results suggest a prolonged drug release from the nanoparticles. The results of nanoparticles interaction with mucin show their mucoadhesivity and ability to interact with the ocular surface increasing the drug residence time in the eye. The prepared nanoparticles were subjected to stability and microbiological studies with satisfactory results. In conclusion, Chitosan/TPP-Hyaluronic Acid nanoparticles proved to be a promising platform for ceftazidime delivery in the eye.
O olho é um órgão do corpo humano com uma estrutura e anatomia complexas por apresentar diversas barreiras que impedem que os fármacos possam penetrar para o tratamento das diversas afeções oculares. As barreiras estão presentes tanto ao nível do segmento anterior como posterior. Geralmente, os fármacos são administrados recorrendo à administração tópica e às formas farmacêuticas comuns mas as características únicas dos tecidos oculares e os mecanismos de defesa do globo ocular dificultam a administração de fármacos a este nível, obtendo-se uma baixa resposta terapêutica. Um dos desafios das novas formulações terapêuticas de administração ocular é aumentar a biodisponibilidade dos fármacos administrados topicamente assim como a sua eficácia terapêutica. A administração tópica ocular é desde sempre um desafio devido à dificuldade em manter concentrações adequadas de fármaco no local de aplicação durante tempo suficiente de modo a obter um adequado efeito farmacológico, o que requer repetidas aplicações do fármaco. Estes objetivos podem ser atingidos através do recurso a estratégias que aumentem o tempo de residência pré-corneal, a mucoadesividade e a penetração através dos tecidos. A queratite bacteriana é uma afeção ocular que afeta milhões de pessoas em todo o mundo causando problemas oculares graves podendo mesmo causar cegueira. Esta infeção conduz à destruição da córnea e tem como principais agentes patogénicos Staphylococcus aureus, Staphylococcus coagulase-negativo, Pseudomonas aeruginosa, Streptococcus pneumonia e Serratia. O projeto desenvolvido visa utilizar a ceftazidima, antibiótico da classe das cefalosporinas de terceira geração, que atua na inibição da síntese da parede bacteriana, no combate ao principal agente causador da queratite bacteriana, mas não da forma convencional em que são normalmente utilizados. Para melhorar o tempo de residência do fármaco, foram desenvolvidas nanopartículas poliméricas. Estas nanopartículas foram desenvolvidas por gelificação inotrópica entre quitosano e tripolifosfato às quais foi adicionado ácido hialurónico. Os componentes foram selecionados com base nas suas características de biodegradabilidade, biocompatibilidade e mucoadesão com as glicoproteínas da córnea e conjuntiva. O ácido hialurónico foi selecionado pela sua interação com os recetores CD44 presentes na córnea e conjuntiva oculares facilitando a penetração das nanoparticulas a nível ocular. Para o desenvolvimento das nanopartículas várias proporções dos três principais componentes foram sendo testadas variando a sua quantidade, proporções e pH do meio. Estas variações foram necessárias para verificar as condições ideais para que, por um lado ocorresse a formação das nanopartículas e por outro que estas se mantivessem estáveis e não precipitassem. Para que as nanopartículas possam ser corretamente utilizadas têm que ter um veículo que permita a sua administração. O veículo foi desenvolvido utilizando polímeros mucoadesivos derivados da celulose, a arboximetilcelulose e hidroxipropilmetilcelulose utilizados também como agentes viscosificantes e que foram testados em diferentes concentrações. Testes de viscosidade, potencial zeta e compatibilidade com as nanopartículas produzidas foram desenvolvidos para chegar ao polímero e concentração ideais para funcionar como veículo. As formulações foram caracterizadas em termos de pH, osmolalidade, viscosidade, potencial zeta, distribuição de tamanho das nanoparticulas e eficiência de encapsulação do fármaco. Adicionalmente foram realizados estudos in vitro de libertação e cedência que demonstram uma libertação continuada do fármaco a partir das nanopartículas formuladas. Estudos de viscosidade e potencial zeta foram também desenvolvidos na avaliação da interação entre a formulação e a mucina ocular comprovando-se a mucoadesividade que permite prolongar o tempo de residência ocular e a libertação do fármaco. As nanopartículas desenvolvidas foram sujeitas a estudos microbiológicos demonstrando ter atividade contra agentes causadores da queratite bacteriana. Os estudos de toxicidade desenvolvidos demonstraram resultados satisfatórios pois indicaram que a formulação não teve efeitos citotóxicos nas linhas celulares testadas. Em conclusão, as nanopartículas de quitosano/TPP-Ácido Hialurónico são uma promissora formulação ocular para a veiculação da ceftazidima, promissora no tratamento da queratite bacteriana.

Adaptive optics (AO) systems make use of active optical elements, namely wavefront correctors, to improve the resolution of imaging systems by compensating for complex optical aberrations. Recently, magnetic fluid deformable mirrors (MFDM) were proposed as a novel type of wavefront correctors that offer cost and performance advantages over existing wavefront correctors. These mirrors are developed by coating the free surface of a magnetic fluid with a thin reflective film of nano-particles. The reflective surface of the mirrors can be deformed using a locally applied magnetic field and thus serves as a wavefront corrector. MFDMs have been found particularly suitable for ophthalmic imaging systems where they can be used to compensate for the complex aberrations in the eye that blur the images of the internal parts of the eye. However, their practical implementation in clinical devices is hampered by the lack of effective methods to control the shape of their deformable surface. The research work reported in this thesis presents solutions to the surface shape control problem in a MFDM that will make it possible for such devices to become integral components of retinal imaging AO systems. The first major contribution of this research is the development of an accurate analytical model of the dynamics of the mirror surface shape. The model is developed by analytically solving the coupled system of fluid-magnetic equations that govern the dynamics of the surface shape. The model is presented in state-space form and can be readily used in the development of surface shape control algorithms. The second major contribution of the research work is a novel, innovative design of the MFDM. The design change was prompted by the findings of the analytical work undertaken to develop the model mentioned above and is aimed at linearizing the response of the mirror surface. The proposed design also allows for mirror surface deflections that are many times higher than those provided by the conventional MFDM designs. A third contribution of this thesis involves the development of control algorithms that allowed the first ever use of a MFDM in a closed-loop adaptive optics system. A decentralized proportional-integral (PI) control algorithm developed based on the DC model of the wavefront corrector is presented to deal mostly with static or slowly time-varying aberrations. To improve the stability robustness of the closed-loop AO system, a decentralized robust proportional-integral-derivative (PID) controller is developed using the linear-matrix-inequalities (LMI) approach. To compensate for more complex dynamic aberrations, an Hinf controller is designed using the mixed-sensitivity Hinf design method. The proposed model, design and control algorithms are experimentally tested and validated.

Trabalho Final de Mestrado Integrado, Ciências Farmacêuticas, Universidade de Lisboa, Faculdade de Farmácia, 2014
Ao longo dos últimos anos têm se verificado um aumento de doenças oftalmológicas em todo o mundo, tendo sido feito um esforço para prevenir e curar essas patologias. Através da utilização de sistemas de libertação controlada tem sido possível o tratamento destas doenças, mas existem ainda problemas que precisam de ser ultrapassados. O uso de copolímeros como sistemas de libertação de farmacos permitiu uma evolução no domínio da saúde, controlando estes mesmos problemas. Um destes copolímeros são hidrogeles in situ, tais como o ReGel, um copolímero triblocado ABA, que permanecem no corpo durante um longo período de tempo, aumentando a biodisponibilidade das drogas neles dispersas. O ReGel é um polimero hidrosolúvel e biodegradavel a temperaturas inferiores à temperatura de transição, formando assim um gel insoluvel em agua após a sua injecção. Ao longo deste trabalho foram realizados estudos para verificar como Triamcinolona, um corticosteróide sintético de longa ação com forte atividade glucocorticóide, é distribuído através do veículo, analisando o seu perfil de libertação e a homogeneidade da substância. Para este efeito, foi utilizado o método de Cromatografia Líquida de Ultra Performance (UPLC), que permite não só a realização de ensaios mais rápidos, assim como uma análise mais cuidada, precisa e exacta dos resultados.
Over the last few years has been verified an increase of ophthalmic diseases throughout the world, having been made an effort to prevent and cure such diseases. Through the use of controlled release systems has been possible to treat these diseases, but there are still problems that need to be overcome. The use of copolymers as drug release systems allowed an evolution in the field of health, controlling these same problems. One of these copolymers are hydrogels in situ, such as ReGel, a ABA Triblock copolymer, which remain in the body for a long period of time, increase the bioavailability of drugs dispersed therein. ReGel is a water soluble, biodegradable polymer at temperatures below the gel transition temperature that forms a water-insoluble gel once injected. Throughout this paper studies were carried out to verify how Triamcinolone, a long-acting synthetic corticosteroid with strong glucocorticoid activity, is distributed in the vehicle dissolution, analyzing their release profile and homogeneity of substance. For this purpose we used the method of Ultra Performance Liquid Chromatography (UPLC), which allows not only a faster experiment but also more accurate and precise analysis.