Rates of spectacle wear in early childhood in the Netherlands

BACKGROUND: Refractive errors are relatively common all around the world. In particular, early onset myopia is associated with a significant burden in later life. Little is known about refractive errors in preschool children. The aim of this study was to assess the prevalence of spectacle wear, visual acuity and refractive errors in young Dutch children. METHODS: We analyzed data of three prospective population-based studies: 99,660 3- to 5-year-olds undergoing vision screening at preventive child healthcare organizations, 6934 6-year-olds from the Generation R study, and 2974 7-year-olds from the RAMSES study. Visual acuity was measured with Landolt-C or LEA charts, spectacle wear was assessed, and refractive errors at age 6 and 7 were measured with cycloplegic refraction. RESULTS: The prevalence of spectacle wear ranged from 1.5 to 11.8% between 3 to 7 years with no significant gender differences. Among children with spectacle wear at 6 years (N = 583) and 7 years (N = 350) 29.8 and 34.6% had myopia respectively, of which 21.1 and 21.6% combined with astigmatism; 19.6 and 6.8% had hyperopia, 37.2 and 11.1% hyperopia and astigmatism, and 12.5 and 32.7% astigmatism only. CONCLUSIONS: Spectacle wear in European children starts early in preschool and increases to a relatively frequent visual aid at school age. Advocating early detection and monitoring of refraction errors is warranted in order to prevent visual morbidities later in life

MOESM1 of Acute cerebellitis in adults: a case report and review of the literature

Additional file 1: Table S1. Clinical characteristics, etiology and outcome of 35 adult patients with acute cerebellitis confirmed by MRI. This file contains a spreadsheet of the data extracted from the articles describing patients with MRI-confirmed acute cerebellitis

MOESM1 of Acute cerebellitis in adults: a case report and review of the literature

Additional file 1: Table S1. Clinical characteristics, etiology and outcome of 35 adult patients with acute cerebellitis confirmed by MRI. This file contains a spreadsheet of the data extracted from the articles describing patients with MRI-confirmed acute cerebellitis

Serum levels of bupivacaine after pre-peritoneal bolus vs. epidural bolus injection for analgesia in abdominal surgery: A safety study within a randomized controlled trial

Continuous wound infiltration (CWI) has become increasingly popular in recent years as an alternative to epidural analgesia. As catheters are not placed until the end of surgery, more intraoperative opioid analgesics might be needed. We, therefore, added a single pre-peritoneal bolus of bupivacaine at the start of laparotomy, similar to the bolus given with epidural analgesia. This was a comparative study within a randomized controlled trial (NTR4948). Patients undergoing hepato-pancreato-biliary surgery received either a pre-peritoneal bolus of 30ml bupivacaine 0.25%, or an epidural bolus of 10ml bupivacaine 0.25% at the start of laparotomy. In a subgroup of patients, we sampled blood and determined bupivacaine serum levels 20, 40, 60 and 80 minutes after bolus injection. We assumed toxicity of bupivacaine to be >1000 ng/ml. A total of 20 patients participated in this sub-study. All plasma levels measured as well as the upper limit of the predicted 99% confidence intervals per time point were well below the toxicity limit. In a mixed linear-effect model both groups did not differ statistically significant (p = 0.131). The intra-operative use of opioids was higher with CWI as compared to epidural (86 (SD 73) μg sufentanil vs. 50 (SD 32). In this exploratory study, the pre-peritoneal bolus using bupivacaine resulted in serum bupivacaine concentrations well below the commonly accepted toxic threshold. With CWI more additional analgesics are needed intraoperatively as compared to epidural analgesia, although this is compensated by a reduction in use of vasopressors with CWI. Netherlands Trial Register NTR494

Baseline characteristics of the 20 participants.

<p>Baseline characteristics of the 20 participants.</p

Mean plasma levels of bupivacaine per time point in ng/ml.

<p>Time point 1-2-3-4 are 20, 40, 60 and 80 minutes after bolus injection. The green bar is the mean, the error line the upper limit of the 99% confidence interval. Since toxicity symptoms can occur from 1000ng/ml we chose that as the upper limit of the Y-axis.[<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0178917#pone.0178917.ref017" target="_blank">17</a>, <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0178917#pone.0178917.ref018" target="_blank">18</a>]</p