Risk factors and characteristics of new-onset coronary heart disease in adults with physical disabilities: A retrospective cohort study.

Objectives: There is limited information about coronary heart disease (CHD) in adults with physical disabilities. This study was performed to assess the incidence and predictors of the new development of CHD in adults with physical disabilities. Methods: A retrospective cohort study was performed on 3902 physically disabled people in Shanghai, China. Baseline information was collected in January 2012, and participants were followed-up with for 7.5 years for CHD events. Risk factors for demographic characteristics, disease history, electrocardiography, and blood biochemical indicators were evaluated using a Cox proportional hazard model. Subgroup analyzes were performed according to gender and level of physical disability. Results: Out of the total 3902 adults with physical disabilities (average age 55.9 ± 8.5 years), 468 (12.0%) developed CHD, during a median follow-up period of 7 years. Independent predictors of CHD included the following: age (HR = 1.411, 95% CI = 1.255-1.587, p＜0.001), gender (HR = 0.773, 95% CI = 0.637-0.940, p = 0.010), abnormal electrocardiogram(HR = 1.396, 95% CI = 1.088-1.792, p = 0.009), hypertension (HR = 1.657, 95% CI = 1.369-2.006, p＜0.001), diabetes (HR = 1.649, 95% CI = 1.307-2.081, p＜0.001), serum uric acid (HR = 1.001, 95% CI = 1.000-1.002, p = 0.046), and total cholesterol (HR = 1.416, 95% CI = 1.054-1.902, p = 0.021). In addition to the risk factors of the total population with physical disability, triglyceride was also a significant risk factor for CHD in the subgroup with women and mild disability. Conclusions: During a 7.5 years period, the CHD incidence rate among physically disabled people was 12.0%. We identified the role of CHD risk factors such as age, gender, hypertension, diabetes, serum uric acid, total cholesterol, and abnormal electrocardiogram.

Vision therapy for intermittent exotropia: A case series

Introduction: We evaluated the effectiveness of office-based vergence/accommodative therapy with home reinforcement for intermittent exotropia in a private practice environment. Methods: This was a retrospective chart review study. Patients who received office-based vision therapy for intermittent exotropia in a private optometric clinic were reviewed. Patients with intermittent exotropia treated with and without strabismus surgery were both included. The pre-therapy baseline data were compared to the re-evaluation data obtained at the last therapy session. All patients received office-based vergence/accommodative therapy administered by a trained therapist during a 60 min office visit every one to two weeks, combined with home reinforcement for a minimum of 15 min, five times per week. The primary outcome measure in this study was the change in the Office Control Score from the pre-therapy visit to the post-therapy visit. The hypothesis was that office-based vergence/accommodative therapy would significantly improve the Office Control Score. Results: Forty patients aged from 5 to 22 years old fulfilled the inclusion criteria. Eight of them were postoperative patients. After treatment, there was a change of −1.1 ± 1.6 (p < 0.001, z = 3.73, effect size: 0.42) and −1.1 ± 1.4 (p < 0.001, z = 4.26, effect size: 0.48) in distance and near Office Control Score, respectively. In the subgroup analysis, significant improvements in the Office Control Score were observed in both the operated and unoperated intermittent exotropes at distance and near. Conclusion: This study showed that office-based vergence/accommodative therapy with home reinforcement significantly improved the distance and near control of exodeviation in both operated and unoperated intermittent exotropia patients in a private practice environment. (AU)

Vision therapy for intermittent exotropia: A case series.

INTRODUCTION: We evaluated the effectiveness of office-based vergence/accommodative therapy with home reinforcement for intermittent exotropia in a private practice environment. METHODS: This was a retrospective chart review study. Patients who received office-based vision therapy for intermittent exotropia in a private optometric clinic were reviewed. Patients with intermittent exotropia treated with and without strabismus surgery were both included. The pre-therapy baseline data were compared to the re-evaluation data obtained at the last therapy session. All patients received office-based vergence/accommodative therapy administered by a trained therapist during a 60 min office visit every one to two weeks, combined with home reinforcement for a minimum of 15 min, five times per week. The primary outcome measure in this study was the change in the Office Control Score from the pre-therapy visit to the post-therapy visit. The hypothesis was that office-based vergence/accommodative therapy would significantly improve the Office Control Score. RESULTS: Forty patients aged from 5 to 22 years old fulfilled the inclusion criteria. Eight of them were postoperative patients. After treatment, there was a change of -1.1 ±â€¯1.6 (p < 0.001, z = 3.73, effect size: 0.42) and -1.1 ±â€¯1.4 (p < 0.001, z = 4.26, effect size: 0.48) in distance and near Office Control Score, respectively. In the subgroup analysis, significant improvements in the Office Control Score were observed in both the operated and unoperated intermittent exotropes at distance and near. CONCLUSION: This study showed that office-based vergence/accommodative therapy with home reinforcement significantly improved the distance and near control of exodeviation in both operated and unoperated intermittent exotropia patients in a private practice environment.

The new clinical skills training module for the master's degree in ophthalmology.

This article aims at the principle problems noticed in the process of training postgraduates in ophthalmology for clinical skills (POCs). Alteration of the training objectives and training curricula, as well as the clinical department training plans, will allow POCs to obtain a systematic and standardized education to establish their general attitude toward medical life and career plans. This will help to improve their clinical skills and establish professional ethics that will protect the interests of patients and promote the healthy and harmonious development of the Eye Hospital. Furthermore, the Ophthalmology Center could cultivate a number of outstanding postgraduate students that match its tier, to describe the quality of the training for the master's degree in Ophthalmology.