The mediating role of nurses' professional commitment in the relationship between core self-evaluation and job satisfaction.

OBJECTIVES: The aim of this study has been to examine the degree to which it is possible to predict job satisfaction in hospital nurses based on core self-evaluation and the nurses' professional commitment. Psychological constructs of nurses' professional commitment could predict a level of job satisfaction. MATERIAL AND METHODS: A cross-sectional design was applied. Data was collected from 584 nurses of the University Hospital Osijek between April and November 2016. Core Self-Evaluation Scale (CSES), Job Satisfaction Survey (JSS) and Nurses' Professional Commitment Scale (NPCS) were administrated to the study participants. Confirmatory factor analyses were conducted to test the validity of each questionnaire. Structural equation modeling was used for testing the prediction of nurses' professional commitment and core self-evaluation of job satisfaction. Nurses' professional commitment is variable, which functions as a mediator between predictor (core selfevaluation - CSE) and criterion variable (job satisfaction - JS). As a mediator, it explains what the effect is, provided that correlations among all variables are significant. RESULTS: The correlation analyses reveal significant positive correlations between job satisfaction and core self-evaluation (r = 0.441, p > 0.001) as well as between job satisfaction and nurses' professional commitment (r = 0.464, p > 0.001). Furthermore, core self-evaluation significantly and positively correlates with nurses' professional commitment (r = 0.402, p > 0.001). The results have shown that nurses' professional commitment mediates the relationship between core self-evaluation and job satisfaction. The bootstrap analysis showed that core self-evaluation partially mediated the relationship between nurses' professional commitment and job satisfaction (ß = 0.78, p < 0.001**). The indirect effects of core self-evaluation on job satisfaction through nurses' professional commitment was also significant (ß = 0.17, p < 0.001**). CONCLUSIONS: Nurses who are more committed to their work, regardless of the structure of personality, have greater satisfaction in their work. Int J Occup Med Environ Health 2018;31(5):649-658.

Erlotinib-induced Rosacea-like Dermatitis.

Skin and skin adnexa toxicities are the most common side effects associated with epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) and occur in most patients receiving this therapy. The majority of these cutaneous side effects are transient, reversible, and dose dependent. Although these symptoms are in general not severe, they significantly affect quality of life and can have a serious effect on treatment compliance as well as the treatment regimen. The most common early symptoms present as papulopustules on an erythematous base, usually localized in seborrheic areas. This clinical presentation is commonly described as "acneiform", although these adverse reactions have clinical presentations, such as rosacea-like and seborrheic-like dermatitis. In this context, we report a case of a 77-year-old man with a medical history of planocellular lung cancer with ipsilateral pulmonary metastasis and mediastinum infiltration who received erlotinib as a third-line therapy, presenting with centrofacial rosaceiform rash as a side effect associated with the use of EGFR-TKIs. The patient had a negative previous history of rosacea. Therefore, symptoms probably occurred as an adverse reaction due to the oncological therapy. Current terminology of early cutaneous adverse reactions caused by EGFR-TKIs refers to "acneiform" or "papulopustular" lesions, excluding less common side effects such as rosacea-like dermatitis so these symptoms might be overlooked and misdiagnosed. Thus, we would like to emphasize the importance of developing a more accurate classification of terms in order to provide early detection of all possible cutaneous side effects, including less common ones, providing specific and timely treatment, and allowing continuation of drug therapy.

Ocular surface changes in glaucoma patients related to topical medications.

Topical glaucoma therapy is a long termed, usually lifelong. Antiglaucomatous drugs have toxic effects on ocular surface, due to preservative toxicitiy or the drug itself. Adding a lubricant eyedrops to antiglaucomatous therapy, especially if considering the preservative used, can have protective effect. The purpose of this study was to evaluate the stabilty of precorneal tear film in glaucoma patient prior and after administration of lubricant eye drops with different tipe of preservatives. The study showed the protective role of ocular surface lubrication especially when using drugs with less harmful preservatives.

Ex-PRESS miniature glaucoma shunt in treatment of refractory glaucoma.

Refractory glaucoma in a complicated type of glaucoma of different ethyologies with one same characteristic--intraocular pressure of great resistance to therapy. There are different methods of treatment in such glaucomas, primary surgical options. Ex-PRESS miniature glaucoma shunt implantation was our treatment of choice. In our group of patients we achieved stabile intraocular pressure values in 4 month period of time with no serious or unexpected complications.

Comparison of IOL--master and ultrasound biometry in preoperative intra ocular lens (IOL) power calculation.

Postoperative refractive outcome largely depends on the accuracy of calculating power of implanted IOL. Lens power calculation can be done by conventional ultrasound biometry and partial coherence laser interferometry (IOL Master). The aim was to compare the accuracy of IOL power calculations using conventional ultrasound biometry and partial coherence laser interferometry.40 eyes were included in this prospective randomized trial. Twenty eyes underwent IOL master and 20 eyes had aplanation ultrasound biometry. There were included only eyes with age-related cataract and postoperative natural visual acuity (VA) 0.7. Visual acuity was performed 6 weeks after cataract surgery. After 6 weeks best natural visual acuity were 0.9 (± 0.1) in IOL-Master group and 0.85 (± 0.15) in ultrasound biometry. The postoperative mean absolute refractive error was 0.75 (± 0.5) D for ultrasound biometry and 0.50 (± 0.50) D for IOL-Master. Optical biometry with the IOL-Master proved to be slightly more accurate than ultrasound biometry for IOL power calculation.

Capsular tension ring in damaged zonules.

Capsular tension ring (CTR) is endocapsular support device important during cataract surgery in eyes with weak zonular apparatus. It was presented our experience, advantages and limitations of CTR in phacoemulsification cataract surgery with damaged zonules. Phacoemulsification surgery was performed by clear corneal technique using topical anesthesia. Capsular ring was implanted to stabilize the capsular bag before implantation of intraocular lens. CTR has become increasingly important in the management of zonular weakness during cataract extraction. It lowers the incidence of capsule contraction, stabilizes the capsular bag and enhances IOL centration.

Combined procedure of phacoemulsification and implantation of Ex-PRESS miniature glaucoma shunt.

Glaucoma patients not responding to maximum medical therapy with coexistent cataract are candidates for combined cataract and glaucoma therapy. There are different therapy models. The choice of therapy depends on numerous patient and surgeon related factors. Ex-PRESS mini glaucoma shunt is a modified trabeculectomy and can be combined with cataract surgery when indicated. In this paper we presented our experience with this combined procedure. Our results showed good intraocular pressure control and visual acuity improvement, comparable to other therapy choices.

Palisaded neutrophilic and granulomatous dermatitis in association with subcutaneous nodular and systemic sarcoidosis.

Palisaded neutrophilic granulomatous dermatitis (PNGD) is a rare entity that has been clearly defined neither clinically nor histopathologically. PNGD has been associated with some immune-mediated disorders such as rheumatoid arthritis, systemic lupus erythematosus, systemic vasculitis, Behçet's disease, as well as with lymphoproliferative conditions, bacterial endocarditis, sarcoidosis, and various drugs. We present a 44-year-old Caucasian woman with roundish erythematous-livid plaque and erythematous papules on the left calf that were present for three months. Histopathology of plaque lesion showed palisading neutrophilic and granulomatous dermatitis. Subsequently, she developed a firm and tender nodule on the right calf. Histopathology of the nodule showed typical naked sarcoid granulomas in the dermis and subcutis. Additionally, the patient developed non-tender subcutaneous nodules on the cheeks, submandibular region and left breast with normal overlying skin, which were histopathologically diagnosed as sarcoid granuloma. Red eyes and lower visual acuity on the right eye were diagnosed as anterior uveitis. Therefore, systemic sarcoidosis was established. This is a case of PNGD described in an adult patient with sarcoidosis with cutaneous, breast, eye and lung involvement established by clinical, radiographic, laboratory, and histopathologic criteria.

Safety and efficacy of monotherapy change to fixed combination (travoprost 0.004%/timolol 0.5%) in 6 months follow up period.

PURPOSE: To assess the safety and efficacy of changing antiglaucoma therapy to the travoprost 0.004%/timolol 0.5% (TTFC) fixed combination from previous monotherapies. METHODS: Prospective, open-label, observational, multicenter cohort. A change was done from prior monotherapy at day 0 to TTFC dosed once a day, regardless in the evening or in the morning, without washout period. Active evaluation of systemic and local tolerability (adverse events), and efficacy. i.e., intraocular pressure (IOP) lowering was done at control 1 (day 30), control 2 (day 90) and control 3 (day 120). RESULTS: 40/155/170 patients (79/309/339 eyes) completed the study (120 days/ 90 days/baseline, respectfully). At control 1 excluded were patients with low tolerability (severe hyperemia (6 patients), discomfort (4), chest pain (1)) and non responders (IOP lowering less than 15% from baseline IOP or target IOP >18 mmHg (4 patients)). Mean IOP at control 1 was 15.92 +/- 1.85 mm Hg (21.66% reduction) for 155 patients (non responders excluded), at control 2 was for 155 patients 15.67 +/- 2.17 mm Hg (21.14% reduction), and at control 3 for 40 patients 16.28 +/- 1.59 mm Hg (19.86% reduction). At control 2 analysis of IOP reduction by 4 groups of previous monotherapy (timolol 0,5% (N = 33/66), latanoprost 0.005% (N = 49/98), betaxolol 0.5% (N = 30/60), and travoprost 0.004% (N = 43/85) was performed. 40 patients/79 eyes endured to control 3 (after day 90 free samples were not available for all patients). Analysis of IOP reduction by 4 groups of previous monotherapy medications was performed (timolol 0.5% (N = 7/14), latanoprost 0.005% (N = 14/28), betaxolol 0.5% (N = 7/14), travoprost 0.004% (N = 12/23)). CONCLUSIONS: Changing patients from prior monotherapy to TTFC can provide on average a further reduction in IOP, while demonstrating a favorable safety profile.

Neurofibromatosis type 1 associated with dysplastic nevus syndrome.

Neurofibromatosis type 1 (NF-1) is an autosomal dominant disorder that primarily affects the development and growth of neural cell tissues. It causes tumors to grow on nerves and produces other abnormalities such as skin changes and bone deformities. Dysplastic nevus syndrome (DNS) represents multiple atypical nevi associated with polygenetic inheritance pattern and may rarely occur together with NF-1. DNS type A is a marker of increased melanoma risk, while melanoma has been rarely reported in patients with NF-1. We describe a case of NF-1 type A with DNS presenting with multiple neural tumors, cafe-au-lait spots, hamartomas in globus pallidus and pigmented melanocytic iris hamartomas (Lisch nodules). The importance of close follow up of nevi in such patients with NF-1 and DNS for the development of melanoma as well as other NF-1 associated skin disorders and with multidisciplinary approach to other associated diseases is highlighted.

Comparison of the effect of two viscoelastic agents on an early postoperative intraocular pressure.

This prospective study compares the effect of two viscoelastic agents (Viscoat and Provisc) on an early postoperative intraocular pressure after phacoemulsification and intraocular lens implantation. The study compares 36 patients with senile cataract. Intraocular pressure (IOP) was measured by standard Goldmann aplanation tonometry preoperatively as well as on the first postoperative day, after 24 hours and 1 week postoperatively. The mean postoperative IOP at first postoperative day in the Viscoat group was 24.2 mmHg and in the Provisc group was 21.2 mmHg. The increase was significantly higher in the Viscoat group than in the Provisc group but after 24 hours and 1 week postoperatively the mean IOP was not statisticaly different. The two viscoelastic agents cause equivalent pressure elevation postoperatively.

Multiple sclerosis and neuro-ophthalmologic manifestations.

The authors report clinical features of ocular manifestations in patients with multiple sclerosis (MS), those that affect the visual sensory system and those that affect the ocular motor system. Disturbances of visual sensory function may precede, manifest coincidentally or follow the neurologic manifestations. Visual disturbances are common in MS and often a result of acute demyelinating optic neuropathy. Careful examination of MS patients, who have never suffered optic neuritis, may also reveal asymptomatic visual loss. Asymptomatic visual loss seems to be a universal feature of MS. Patients with multiple sclerosis may develop disorders of fixation, ocular motility and ocular alignment. Disorders of ocular motor system are frequently the initial sign of multiple sclerosis and occur as its presenting sign weeks, month, or years before other neurologic symptoms and signs develop.

Incidence of acute angle-closure glaucoma in Dalmatia, southern Croatia.

AIM: To investigate the incidence of acute angle-closure glaucoma among residents of Dalmatia, southern part of Croatia. METHODS: We reviewed hospital records of 176 patients with acute angle-closure glaucoma treated between January 1995 and December 2001 at the Departments of Ophthalmology at four hospitals in Dalmatia. There were 122 women, aged between 29 and 89 years (median age; 68 years), and 54 men, aged between 33 and 88 years (median age, 70 years). RESULTS: The unadjusted crude incidence was 2.9/100,000 (95% confidence interval [CI], 1.6-4.5). The unadjusted crude incidence among men and women was 1.9 (95% CI, 0.3-3.8) and 3.9 (95% CI, 1.7-6.1) cases/100,000 per year, respectively. The relative risk (RR) of developing acute angle-closure glaucoma was 2.1 (95% CI, 1.5-2.9) times higher for women as compared to men. The RR of acute angle-closure glaucoma was 1.9 (95% CI, 0.6-6.2) in the 40-49 years group, 6.5 (95% CI, 2.3-18.8) in the 50-59 years group, 17 (95% CI, 6.3-47.8) in the 60-69 years group, and 28 (95% CI, 10.4-77.3) in the over 69 years group. The median time from the onset of symptoms to presentation at the hospital was 2 days (range, 1-15 days). In 87 (48%) patients intraocular pressure control was achieved by medical treatment, 41 (23%) patients underwent peripheral iridectomy, and 48 (27%) patients required a trabeculectomy. In 35 (73%) out of 48 patients managed by filtering surgery, the delay in treatment was 3 or more days. In 34 (19%) eyes with final visual acuity 0.1 or worse, the delay in presentation was 3 days or more. No statistically significant association was found between acute angle-closure glaucoma and seasonal variation (chi-square=0.85; p=0.8). CONCLUSION: Earlier recognition of the patients with acute angle-closure glaucoma and a shorter time of delay in presentation could have saved many patients from surgery and vision loss each decade.

A contribution to the surgery of the trachomatous entropion and trichiasis.

Although the WHO document WHO/PBL/93.29 recommends the bilamellar tarsal rotation operation for trachomatous entropion, we will describe another operation that has proved to be very reliable. It is a combined method, consisting of the modified tarsal wedge resection and the eversion splinting-grey line incision. A possible additional correction of the grey line incision on the first postoperative day improves the results. A total of 708 eyes with moderate trachomatous entropion and major trichiasis underwent this surgery, but only 508 of these were followed up during a 6-month period. The rate of failed operations, which consisted of incomplete closure of the lids or more than two inverted lashes remaining, was 6.9%.