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Bernard Schwartz - One of the best experts on this subject based on the ideXlab platform.

  • decrease of optic disc cupping and Pallor of ocular hypertensives with timolol therapy
    Acta Ophthalmologica Scandinavica, 2009
    Co-Authors: Bernard Schwartz, Takenori Takamoto, Philip T Lavin, Daniel Araujo, Gerard Smits
    Abstract:

    . Purpose: The purpose of this study was to determine whether timolol drops compared to placebo drops had a significant effect on optic disc cupping and Pallor in ocular hypertensives. Methods: Thirty-seven ocular hypertensives were randomly assigned to placebo or 0.5% timolol drops to both eyes in a double masked clinical trial. Measurements of ocular pressure and photographs of the optic disc for cupping by photogrammetry and Pallor by computerized image analysis were made at about 3 month intervals, for 18 to 24 months of follow-up. Results: None of the subjects developed visual field loss when tested with the Goldmann perimeter by kinetic and static means at six month intervals. Subjects treated with timolol developed a significant decrease in ocular pressure and a significant decrease in optic disc cupping with a smaller decrease in Pallor compared to subjects treated with placebo. Multivariate analyses indicated that the decrease of optic disc cupping and Pallor was not associated with the ocular pressure on treatment or the decrease in ocular pressure during the trial. Conclusion: Timolol treatment was associated with a decrease in optic disc cupping and Pallor. The effect of timolol appears to be related to mechanisms other than the decrease in ocular pressure.

  • three dimensional evaluation of optic disc Pallor in open angle glaucoma
    Acta Ophthalmologica, 2009
    Co-Authors: Mary Jo Sagaties, Bernard Schwartz
    Abstract:

    : We evaluated the extent of Pallor on the walls of the optic cup three-dimensionally using simultaneous stereophotographs of the optic discs of 29 normals, 29 ocular hypertensives and 28 primary open angle glaucomas. Pallor was located at the bottom of the optic cup. Pallor ascends the walls of the cup as its extent increases. Statistically significant differences in the extent of Pallor in all four quadrants of the optic cup were observed, with the glaucomas having greater extents of Pallor than ocular hypertensives, and the ocular hypertensives greater than the normals. The greatest percentage increase in mean Pallor from normals to open angle glaucomas occurred on the nasal and inferior walls. This differential extent of Pallor could be useful in characterizing ocular hypertension and chronic open angle glaucoma.

  • computerized measurement of the three dimensional distribution of optic disc Pallor
    Current Eye Research, 1997
    Co-Authors: Mary Jo Sagaties Farmer, Bernard Schwartz, Takenori Takamoto
    Abstract:

    PURPOSE. To describe a method which provides quantitative measurements of the surface area of Pallor in each quadrant of the three-dimensional optic cup, using photogrammetric measurements from simultaneous stereophotographs and computerized image analysis. METHODS. Simultaneous stereophotographs of one normal subject and two subjects with primary open angle glaucoma were digitized and analyzed for depth measurements. The boundaries of the optic disc, optic cup and region of Pallor were identified. Pallor/disc and Pallor/cup ratios were subsequently calculated for the superior, temporal, inferior and nasal walls. RESULTS. A digitized photograph and a Laplacian-filtered image were obtained for each eye to be studied. After processing each stereo pair through a similarity sequential detection-based algorithm, depth measurements are represented as a grey scale image, a contour plot, and a wire mesh, with the boundaries of the optic disc, optic cup and Pallor superimposed. Ratios are given of the surface area...

  • neurorefinal rim area measurements by configuration and by Pallor in ocular hypertension and glaucoma
    Ophthalmology, 1992
    Co-Authors: Anja Tuulonen, Bernard Schwartz, Juhani P Airaksinen, Hannu I Alanko, Pertti A Juvala
    Abstract:

    Purpose: The purpose of this study is to examine the differences between measurements of neuroretinal rim area of the optic disc defined by configuration and by Pallor. Methods: One hundred seventy-one patients were studied (59 with glaucoma, 96 ocular hypertensive patients, and 16 controls). The magnification-corrected neuroretinal rim area was measured from black-and-white stereoscopic paper prints. The central area of Pallor was measured using computer-assisted image analysis techniques. The percentage of central area of Pallor was converted into mm 2 , and an estimate of neuroretinal rim area defined by color was calculated. Results: The correlation between the measurements of neuroretinal rim area by configuration and by Pallor was statistically highly significant (r = 0.89, P r = 0.68, P Conclusion: In clinical routine measurements of the neuroretinal rim area, using both configuration and Pallor definition does not seem to add to the information.

M Weber - One of the best experts on this subject based on the ideXlab platform.

  • evaluation of clinical Pallor in the identification and treatment of children with moderate and severe anaemia
    Tropical Medicine & International Health, 2000
    Co-Authors: Lulu Muhe, Shabbar Jaffar, Birhane Oljira, Hirut Degefu, M Weber
    Abstract:

    BACKGROUND: Anaemia from malaria is a common problem in developing countries. Blood transfusion in developing countries is available in few hospitals. Children who are severely anaemic and may require urgent blood transfusion usually present to peripheral first-level health facilities from where they must be referred to hospitals. Since most peripheral facilities do not determine haemoglobin levels, the decision on referral has to be made on clinical grounds. OBJECTIVES: To evaluate the sensitivity and specificity of clinical Pallor of the palms, nailbeds, conjunctivae, buccal mucosa or tongue against haemoglobin values and their reproducibility among health workers. METHODS: A total of 2540 children 2 months to 5 years of age presenting to a rural health centre in Ethiopia were enrolled. Clinically detected Pallor was compared with measured blood haemoglobin concentrations. RESULTS: Any anaemia (haemoglobin < 11 g/dl) was found in 61% of the children. Severe anaemia (haemoglobin < 5 g/dl) was found in 4%. The presence of any Pallor clinically correlated with moderate anaemia (haemoglobin level < 8 g/dl) could be detected with a sensitivity of 95% and a specificity of 64-68% when the palm and nailbeds were used and a sensitivity of 84% and a specificity of 81% when the conjunctivae were used. Severe anaemia was detected clinically as severe Pallor in 50-56% of cases (with a specificity of 95-96%). Agreement between physicians was highest for conjunctivae and nailbed Pallor (87%) and lowest for palm Pallor (73%). Using multivariate analysis, identification of a systolic ejection murmur or altered sensorium, the presence of splenomegaly or malarial parasitaemia were independently predictive of severe and moderately severe anaemia. CONCLUSIONS: Moderate and severe anaemia can be identified clinically in most cases for treatment and referral purposes. A systolic ejection murmur, altered sensorium, the presence of splenomegaly or malarial parasitaemia may be used as additional tools in considering urgent referral for blood transfusion.

  • Pallor as a clinical sign of severe anaemia in children an investigation in the gambia
    Bulletin of The World Health Organization, 1997
    Co-Authors: M Weber, S D Kellingray, Ayo Palmer, Shabbar Jaffar, E K Mulholland, B M Greenwood
    Abstract:

    Most primary health care facilities in Africa must rely on physical signs rather than expensive laboratory tests to detect anemic patients in need of referral for blood transfusion. This study assessed the reliability of simple clinical signs to predict severe anemia in 368 children admitted to a tertiary care hospital (Royal Victoria) in the Gambia primarily with malaria. A trained field assistant examined each child assessing Pallor of the conjunctiva palms and nailbeds on a scale of 0 (no Pallor) to 3 (definite severe Pallor) and looked for signs of respiratory distress. Examination of 173 of these children by a second observer confirmed inter-observer consistency in the detection of Pallor. After the childrens admission their packed cell volume (PCV) was measured. 27% of the children had a PCV under 15% indicative of severe anemia. Multiple regression analysis identified definite Pallor of the conjunctiva definite Pallor of the palms and a "sick" appearance as significant independent predictors of a PCV under 15%. The best predictor a combination of definite Pallor of the conjunctiva and definite Pallor of the palms had a positive predictive value of 67% a sensitivity of 80% and a specificity of 85%. Inclusion of signs of respiratory distress did not improve the prediction. These findings indicate that definite Pallor of the conjunctiva alone or in combination with definite Pallor of the palms can be used in primary health care centers to predict severe anemia with high precision.

Peter D Drummond - One of the best experts on this subject based on the ideXlab platform.

  • Flushing propensity predicts fear of blushing
    Motivation and Emotion, 2020
    Co-Authors: Peter D Drummond
    Abstract:

    The aim of this study was to investigate the association between fear of blushing and self-rated propensity to flush to physical stimuli. Two hundred and five respondents rated fear of blushing, social anxiety, blushing propensity, facial Pallor in threatening situations, and facial flushing to physical exercise, heat and ingesting alcohol. Facial flushing propensity predicted fear of blushing independently of associations with social anxiety, self-rated blushing propensity and other documented predictors. In addition, after controlling for other predictors, facial Pallor in threatening situations was associated with reduced fear of blushing. These findings suggest that a predisposition to flush is a marker of a more general hyper-reactivity of facial blood vessels. This predisposition could increase self-awareness of blushing and the odds that blushing is noticed by others, hence augmenting fear of blushing.

  • correlates of facial flushing and Pallor in anger provoking situations
    Personality and Individual Differences, 1997
    Co-Authors: Peter D Drummond
    Abstract:

    The face usually flushes with rage but can also become pallid during seemingly similar emotional experiences. To investigate this paradox, 200 respondents rated their expected facial colour and the intensity of anger, fear and embarrassment to a range of questionnaire items that involved interpersonal threat or conflict, and also completed questionnaires on blushing propensity, anger expression, facial Pallor and fear of injury. Respondents associated flushing with anger and Pallor with fear, and reported a propensity for facial flushing, linked with blushing, or a propensity for Pallor across a range of threatening and distressing situations. These findings suggest that facial colour during threatening interpersonal interactions may be influenced by fear as well as anger cues which depend, at least in part, on personality attributes.

Craig G Crandall - One of the best experts on this subject based on the ideXlab platform.

Ajith Prabhu - One of the best experts on this subject based on the ideXlab platform.

  • validity of palmar Pallor for diagnosis of anemia among children aged 6 59 months in north india
    Anemia, 2014
    Co-Authors: Arun Kumar Aggarwal, Jaya Prasad Tripathy, Deepak Sharma, Ajith Prabhu
    Abstract:

    Introduction. The Integrated Management of Childhood and Neonatal Illness (IMNCI) recommends the use palmar Pallor to diagnose anaemia. Earlier studies to validate palmar Pallor as clinical sign for anaemia were largely done in African context. There was a need to test validity of palmar Pallor to detect anemia in different settings. Objective. To study the validity and interobserver agreement of palmar Pallor examination to diagnose anemia in children under 5 years of age in India. Methods. In a village in Northern India, hemoglobin estimation was done for 80 children using cyanomethemoglobin method. Two examiners, a physician and a health worker, trained in IMNCI evaluated children for palmar Pallor. Sensitivity and specificity and Kappa statistics were calculated. Results. Health worker diagnosed palmar Pallor with sensitivity of 30.8–42.8% and specificity of 70–89%. Similar figures for doctor were 40–47% and 60–66%, respectively. Kappa agreement between a health worker and a physician was 0.48 (95% CI = 0.298–0.666) and then increased to 0.51 when categories of severe Pallor and mild Pallor were merged. Conclusion. While using palmar Pallor as clinical sign for anaemia, children with no Pallor should also be followed up closely for possible detection of missed cases during follow-up.

  • Validity of Palmar Pallor for Diagnosis of Anemia among Children Aged 6–59 Months in North India
    Anemia, 2014
    Co-Authors: Arun Kumar Aggarwal, Jaya Prasad Tripathy, Deepak Sharma, Ajith Prabhu
    Abstract:

    Introduction. The Integrated Management of Childhood and Neonatal Illness (IMNCI) recommends the use palmar Pallor to diagnose anaemia. Earlier studies to validate palmar Pallor as clinical sign for anaemia were largely done in African context. There was a need to test validity of palmar Pallor to detect anemia in different settings. Objective. To study the validity and interobserver agreement of palmar Pallor examination to diagnose anemia in children under 5 years of age in India. Methods. In a village in Northern India, hemoglobin estimation was done for 80 children using cyanomethemoglobin method. Two examiners, a physician and a health worker, trained in IMNCI evaluated children for palmar Pallor. Sensitivity and specificity and Kappa statistics were calculated. Results. Health worker diagnosed palmar Pallor with sensitivity of 30.8–42.8% and specificity of 70–89%. Similar figures for doctor were 40–47% and 60–66%, respectively. Kappa agreement between a health worker and a physician was 0.48 (95% CI = 0.298–0.666) and then increased to 0.51 when categories of severe Pallor and mild Pallor were merged. Conclusion. While using palmar Pallor as clinical sign for anaemia, children with no Pallor should also be followed up closely for possible detection of missed cases during follow-up.