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PURPOSE: To evaluate the influence of visual field (VF) examinations using modern techniques with short examination times on the intraocular pressure (IOP). METHODS: Sixty-one consecutive patients, aged 28-90 years, 40 women and 21 men, were examined. Forty patients were treated for glaucoma and 21 were untreated patients with ocular hypertension or suspected glaucoma. Twenty-one subjects were examined using the Humphrey Field Analyzer, using SITA programs, and 40 with high-pass resolution perimetry (HRP). Goldmann applanation tonometry was performed immediately before and after the VF examinations. RESULTS: A difference in IOP of more than 2 mm Hg before and after the VF examination was observed in 14 of the 61 patients (23%). The maximum change in each direction was 4 mm Hg. The mean differences were not significant. All eight subjects with increasing IOP after VF examinations were examined using the HRP technique (P=0.04). CONCLUSION: Modern VF techniques with short examination time do not seem to significantly influence IOP.

In order to find out to which extent high-pass resolution perimetry would detect any changes in patients treated for glaucoma, resolution perimetry resultswere evaluated from 56 glaucoma patients and 15 untreated ocular hypertensive patients followed for 2 to 3 years. Fifty-nine of the 71 examined patients showed lower resolution thresholds, i.e. increased sensitivity after 2 years, compared to initial values. The threshold decrease was significantly larger inthe treated glaucoma patients (median 1.22 dB) than in the untreated ocular hypertensive patients (0.48 dB). The threshold decrease in the untreated ocular hypertensive group corresponds to the previously described learning effect. In 35 of the 56 treated glaucoma patients the thresholds improved more than 0.84 dB, the upper confidence limit in the untreated group, which may indicate a beneficial effect of antiglaucoma therapy in these patients.The threshold change was unrelated to initial resolution threshold and cannot be explained by a 'sorting' effect. The observations in the current study using resolution perimetry indicate that improved visual function can be demonstrated in many patients treated for early glaucoma, at least during thefirst 2 years of treatment.

Background: Patients undergoing surgical treatment of abdominal aortic aneurysm (AAA) should receive adequate information about the disease, treatment options, and self-care. Patients' learning needs should be acknowledged. The aim was to describe the perceived learning needs in patients with AAA. A secondary aim was to explore their experience of methods for patient education. Methods: Three focus group interviews were conducted with 14 patients treated with open or endovascular repair of AAA. The interviews embraced initial diagnosis, surgical treatment, and follow-up from a learning perspective and were analyzed using qualitative content analysis. Results: Three categories and 10 subcategories emerged. The health care staff failed to meet the participants' individual learning needs. Participants relied on other pathways to obtain knowledge, such as the internet or anecdotal information from friends and family. Learning needs pertained to risks and complications with surgery, self-care, and rupture risk. The participants were reluctant to ask questions due to a stressful environment. They requested accessible written information, along with a professional contact person for coordination and support during the care pathway. Conclusions: Patients with AAA describe unmet learning needs in regard to risks and complications with the disease and surgical treatment but also disease management and lifestyle factors. Education material should be consistent, individualized and easily accessible for patients and next of kin. Additional psychosocial support is warranted. Adjusting information to patients' needs may improve patient satisfaction.

The following report has been prepared based upon an assignment given by the company, Ortopedic Care Scandinavia AB. The paper is an exam on basic level, 15 credit points at higher level education within product development.

Ortopedic Care Scandinavia AB is working with product development of medical technology products. What makes the corporate unique is the fact that the development is based upon problems encountered by surgeons in their daily work. Suggestions for improvement in technology are given directly by the end users. This paper is based upon such problems.

Product development was made on the medical instrument called, suture passer. The instrument is used in endoscopic surgery of the rotator cuff. The cuff is a group of four muscles (and their respective tendons) that stabilize the shoulder. In case of an accident, mostly sport related, these muscles can loosen from the bone. In surgery a suture passer is then used to penetrate the injured tendon with a needle with an attached suture. The passer creates a loop of suture that can be used to attach the damaged tendon.

The report is based upon the following problem formulations:

• The needle has an inconvenient edge that can damage the muscle.
• The strength of the suture thread is deteriorated by the design of the needle.
• The suture thread has been known to snap when the surgeon apply to much pressure when tying.
• If the patient is suffering from subacromial impingement the jaw of the instrument can appear to be clumsy and hard to open.
• The jaw has sharp teeth which have been known to get stuck in the tendon. The surgeon must then perform an uncontrolled movement which might damage the tendon.
• The jaw limits the surgeons’ choice of thickness of the suture thread.
• The thickness of the needle used in the suture passer is limited to one size. 

The purpose of the project is to develop a new concept that minimizes the risk for the patient and at the same time the concept should facilitate the work of the surgeon. The concept should meet the set requirements and be presented in the form of renderings of CAD-models and drawings.

To achieve this process the instrument uses four different components. The needle, the jaw, the handle and an attachment between the needle and the handle.  Under heading 5, the generating process, each component presents to together with arguments of its design. The instrument consist of 25 components that are all developed from the ground up.

The result should be viewed as a thorough concept that can be used for further development. It is recommended that the next step should be an investigation about material choice. When the material is specified a prototype should be manufacture and then used for testing.