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Publicações

Publicações por João Paulo Cunha

2011

Recent studies provide an updated clinical perspective on blue light-filtering IOLs

Autores
Davison, JA; Patel, AS; Cunha, JP; Schwiegerling, J; Muftuoglu, O;

Publicação
GRAEFES ARCHIVE FOR CLINICAL AND EXPERIMENTAL OPHTHALMOLOGY

Abstract
Recent reviews of blue light-filtering intraocular lenses (IOLs) have stated their potential risks for scotopic vision and circadian photoentrainment. Some authors have challenged the rationale for retinal photoprotection that these IOLs might provide. Our objective is to address these issues by providing an updated clinical perspective based on the results of the most recent studies. This article evaluates the currently available published papers assessing the potential risks and benefits of blue light-filtering IOLs. It summarizes the results of seven clinical and two computational studies on photoreception, and several studies related to retinal photoprotection, all of which were not available in the previous reviews. These results provide a clinical risk/benefit analysis for an updated review for these IOLs. Most clinical studies comparing IOLs with and without the blue light-filtering feature have found no difference in clinical performance for; visual acuity, contrast sensitivity, color vision, or glare. For blue light-filtering IOLs, three comparative clinical studies have shown improved contrast sensitivity and glare reduction; but one study, while it showed satisfactory overall color perception, demonstrated some compromise in mesopic comparative blue color discrimination. Comparative results of two recent clinical studies have also shown improved performance for simulated driving under glare conditions and reduced glare disability, better heterochromatic contrast threshold, and faster recovery from photostress for blue light-filtering IOLs. Two computational and five clinical studies found no difference in performance between IOLs with or without blue light-filtration for scotopic vision performance and photo entrainment of the circadian rhythm. The rationale for protection of the pseudophakic retina against phototoxicity is discussed with supporting results of the most recent computational, in-vitro, animal, clinical, and epidemiological investigations. This analysis provides an updated clinical perspective which suggests the selection of blue light-filtering IOLs for patients of any age, but especially for pediatric and presbyopic lens exchange patients with a longer pseudophakic life. Without clinically substantiated potential risks, these patients should experience the benefit of overall better quality of vision, reduced glare disability at least in some conditions, and better protection against retinal phototoxicity and its associated potential risk for AMD.

1992

AN OBJECT-ORIENTED MODEL FOR AN INTEGRATED CLINICAL NEUROPHYSIOLOGY DEPARTMENT

Autores
CUNHA, JP; CUNHA, JFE; DEOLIVEIRA, PG; DASILVA, AM;

Publicação
PROCEEDINGS OF THE ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY, VOL 14, PTS 1-7

Abstract

2012

The SWORD tele-rehabilitation system

Autores
Bento, VF; Cruz, VT; Ribeiro, DD; Colunas, MM; Cunha, JPS;

Publicação
Studies in Health Technology and Informatics

Abstract
In spite of the growing interest verified in the field of technology-based interventions for Stroke rehabilitation, there is still no global solution that is both successful and suitable for a widespread use [1,2]. In this article, we present a novel tele-rehabilitation tool designed to be used for ambulatory patients, and developed towards the motor recovery of the patient's upper-limb. The SWORD system combines a movement quantification system that analyzes the quality of the motor task performed with a biofeedback console. The proposed structure defines the SWORD system as a complete tele-rehabilitation framework that enables a direct connection between clinical and ambulatory settings. Currently a randomized clinical trial is being designed in order to assess the effectiveness of the SWORD tele-rehabilitation system.

2012

PHealth and wearable technologies: A permanent challenge

Autores
Cunha, JPS;

Publicação
Studies in Health Technology and Informatics

Abstract
Wearable technologies have been evolving towards daily usage and are a major player in the personalized health challenge. In this paper we present a personal view of their evolution, how one of them developed within our lab went to the international market and how this type of technology is being used in pHealth projects for first responder professionals and public transportation drivers.

2009

A MONITORING TOOLKIT FOR A DISTRIBUTED CLINICAL DATA INTEGRATION ENGINE

Autores
Santos, V; Oliveira, D; Oliveira, IC; Cunha, JPS;

Publicação
HEALTHINF 2009: PROCEEDINGS OF THE INTERNATIONAL CONFERENCE ON HEALTH INFORMATICS

Abstract
The Rede Telematica da Saude (RTS) is a telematic network connecting health care providers in the Aveiro region (Portugal), aiming at supporting the continuity of care. Using the RTS, health care professionals and institutions can securely share clinical data. RTS makes use of an integration engine, which accesses the scattered data sources to create a virtual unified view of patients' information. RTS is deployed over a wide-area private network, shared among a great variety of bandwidth links, systems and applications, which can impact the infrastructure service levels in multiple ways. In this paper, we describe the development of a toolkit for monitoring the performance of the distributed integration process. These analysis mechanisms make it is possible to detect bottlenecks and introduce optimizations in the system, especially with respect to the integration engine module. Its deployment in the production RTS health telematic network assists the maintenance team and the decision taking process to handle usage trends and systems needs.

2003

Movement quantification during epileptic seizures: A new technical contribution to the evaluation of seizure semiology

Autores
Cunha, JPS; Vollmar, C; Li, Z; Fernandes, J; Feddersen, B; Noachtar, S;

Publicação
PROCEEDINGS OF THE 25TH ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY, VOLS 1-4: A NEW BEGINNING FOR HUMAN HEALTH

Abstract
In Epilepsy, seizure semiology analysis is routinely used for diagnostic purpose. The behavior of the patient during seizures is usually evaluated by expert qualitative observation where several signs are identified. In the clinical literature, several ictal phenomena are described but still involved in controversy. In this paper, we present our effort to establish a quantified movement analysis method to be widely used as an additional tool to clarify this controversy.

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