Background: Developmental dysplasia of the hip (DDH) is common, affecting 7.3 per 1000 births in South Australia. Clinical screening programmes exist to identify the condition early to gain the maximum benefit from ea...Background: Developmental dysplasia of the hip (DDH) is common, affecting 7.3 per 1000 births in South Australia. Clinical screening programmes exist to identify the condition early to gain the maximum benefit from early treatment. Although these screening programmes are effective, there are still cases that are missed. Previous research has highlighted key risk factors in the development of DDH. Objective: To compare the risk factors of cases of DDH identified late with those that were diagnosed early. Methods: A total of 1281 children with DDH born in 1988- 1996 were identified from the South Australian Birth Defects Register. Hospital records of those who had surgery for DDH within 5 years of life were examined for diagnosis details. Twenty seven (2.1% ) had been diagnosed at or after 3 months of age and were considered the late DDH cases (a prevalence of 0.15 per 1000 live births). Various factors were compared with early diagnosed DDH cases. Results: Female sex, vertex presentation, normal delivery, rural birth, and discharge from hospital less than 4 days after birth all significantly increased the risk of late diagnosis of DDH. Conclusions: The results show differences in the risk factors for early and late diagnosed DDH. Some known risk factors for DDH are in fact protective for late diagnosis. These results highlight the need for broad newborn population screening and continued vigilance and training in screening programmes.展开更多
Objective: To describe a standardized method for reporting quantitative change s in macular thickening using optical coherence tomography (OCT). Methods: The p roposed method consists of calculating the actual change ...Objective: To describe a standardized method for reporting quantitative change s in macular thickening using optical coherence tomography (OCT). Methods: The p roposed method consists of calculating the actual change in central foveal thick ening (the initial pretreatment thickness minus the posttreatment thickness) usi ng OCT and dividing that value by the potential change (the initial pretreatment thickness minus the normal thickness based on normative data) to provide the to tal improvement in macular edema as a percentage. We refer to this method as the standardized change in macular thickening (SCMT). To illustrate the effectivene ss of this method, we performed a retrospective review of 2 studies that evaluat ed different strategies for treating refractory macular edema. Results: Patients treated with intravitreal triamcinolone acetonide for refractory diabetic macul ar edema had an overall SCMT of approximately 75%, 78%, and 55%at the 1-, 3 -, and 6-month follow-up visits, respectively. More than half of the patients in the study cohort (9 of 16 patients) experienced greater than 80%SCMT at the last follow-up visit. Patients who underwent vitrectomy for a taut, thickened posterior hyaloid on OCT responded with an SCMT of approximately 78%at the 3-m onth follow-up visit and 87%at the final follow-up visit (mean, 19 months). P atients who underwent vitrectomy for diabetic macular edema unresponsive to lase r photocoagulation but with no evidence of vitreomacular traction experienced an SCMT of 37%at the 3-month follow-up visit and 20%at the final follow-up vi sit (mean, 17 months). Conclusion: The proposed method offers an objective and i ntuitive basis for evaluating and comparing the efficacy of different therapeuti c modalities.展开更多
文摘Background: Developmental dysplasia of the hip (DDH) is common, affecting 7.3 per 1000 births in South Australia. Clinical screening programmes exist to identify the condition early to gain the maximum benefit from early treatment. Although these screening programmes are effective, there are still cases that are missed. Previous research has highlighted key risk factors in the development of DDH. Objective: To compare the risk factors of cases of DDH identified late with those that were diagnosed early. Methods: A total of 1281 children with DDH born in 1988- 1996 were identified from the South Australian Birth Defects Register. Hospital records of those who had surgery for DDH within 5 years of life were examined for diagnosis details. Twenty seven (2.1% ) had been diagnosed at or after 3 months of age and were considered the late DDH cases (a prevalence of 0.15 per 1000 live births). Various factors were compared with early diagnosed DDH cases. Results: Female sex, vertex presentation, normal delivery, rural birth, and discharge from hospital less than 4 days after birth all significantly increased the risk of late diagnosis of DDH. Conclusions: The results show differences in the risk factors for early and late diagnosed DDH. Some known risk factors for DDH are in fact protective for late diagnosis. These results highlight the need for broad newborn population screening and continued vigilance and training in screening programmes.
文摘Objective: To describe a standardized method for reporting quantitative change s in macular thickening using optical coherence tomography (OCT). Methods: The p roposed method consists of calculating the actual change in central foveal thick ening (the initial pretreatment thickness minus the posttreatment thickness) usi ng OCT and dividing that value by the potential change (the initial pretreatment thickness minus the normal thickness based on normative data) to provide the to tal improvement in macular edema as a percentage. We refer to this method as the standardized change in macular thickening (SCMT). To illustrate the effectivene ss of this method, we performed a retrospective review of 2 studies that evaluat ed different strategies for treating refractory macular edema. Results: Patients treated with intravitreal triamcinolone acetonide for refractory diabetic macul ar edema had an overall SCMT of approximately 75%, 78%, and 55%at the 1-, 3 -, and 6-month follow-up visits, respectively. More than half of the patients in the study cohort (9 of 16 patients) experienced greater than 80%SCMT at the last follow-up visit. Patients who underwent vitrectomy for a taut, thickened posterior hyaloid on OCT responded with an SCMT of approximately 78%at the 3-m onth follow-up visit and 87%at the final follow-up visit (mean, 19 months). P atients who underwent vitrectomy for diabetic macular edema unresponsive to lase r photocoagulation but with no evidence of vitreomacular traction experienced an SCMT of 37%at the 3-month follow-up visit and 20%at the final follow-up vi sit (mean, 17 months). Conclusion: The proposed method offers an objective and i ntuitive basis for evaluating and comparing the efficacy of different therapeuti c modalities.
