Open versus closed view autorefraction in young adults

Purpose: While there are numerous studies comparing open-view autorefractors to subjective refraction or other open-view autorefractors, most studies between closed and open-view autorefraction tend to focus on children rather than young adults. The aim of this study was to determine the concordance in non-cycloplegic refractive error between two modern objective autorefractors: the closed-view monocular Topcon TRK-2P and the binocular open-view Grand Seiko WR-5500. Methods: Fifty young adults aged 20–29 years (mean age 22 ± 1.6 years) underwent non-cycloplegic autorefraction using the Grand Seiko WAM-5500 (open view) and Topcon TRK-2P (closed-view) autorefractors on both eyes. Findings were expressed as the isolated spherical component and were also converted from clinical to vector notation: Mean Spherical Error (MSE) and the astigmatic components J0 and J45. Results: Mean MSE ± SD was −1.00 ± 2.40D for the Grand Seiko WAM-5500 compared to −1.23 ± 2.29D for the Topcon TRK-2P. Up to seventy-six percent of the cohort had mean spherical errors from the Topcon TRK-2P which fell within ±0.50D of the Grand Seiko reading and 58% fell within ±0.25D. Mean differences between the two instruments were statistically significant for all components (J0, spherical, and MSE) (p  0.05). Conclusions: The differences in non-cycloplegic MSE between these two instruments are small, but statistically significant. From a clinical perspective the Topcon TRK-2P may serve as a useful starting point for subjective refraction, but additional work is needed to help further minimise differences between the instruments

Demographic, clinical and antibody characteristics of patients with digital ulcers in systemic sclerosis: data from the DUO Registry

OBJECTIVES: The Digital Ulcers Outcome (DUO) Registry was designed to describe the clinical and antibody characteristics, disease course and outcomes of patients with digital ulcers associated with systemic sclerosis (SSc). METHODS: The DUO Registry is a European, prospective, multicentre, observational, registry of SSc patients with ongoing digital ulcer disease, irrespective of treatment regimen. Data collected included demographics, SSc duration, SSc subset, internal organ manifestations, autoantibodies, previous and ongoing interventions and complications related to digital ulcers. RESULTS: Up to 19 November 2010 a total of 2439 patients had enrolled into the registry. Most were classified as either limited cutaneous SSc (lcSSc; 52.2%) or diffuse cutaneous SSc (dcSSc; 36.9%). Digital ulcers developed earlier in patients with dcSSc compared with lcSSc. Almost all patients (95.7%) tested positive for antinuclear antibodies, 45.2% for anti-scleroderma-70 and 43.6% for anticentromere antibodies (ACA). The first digital ulcer in the anti-scleroderma-70-positive patient cohort occurred approximately 5 years earlier than the ACA-positive patient group. CONCLUSIONS: This study provides data from a large cohort of SSc patients with a history of digital ulcers. The early occurrence and high frequency of digital ulcer complications are especially seen in patients with dcSSc and/or anti-scleroderma-70 antibodies

The health professionals’ perspectives of support needs of adult head and neck cancer survivors and their families: a Delphi study

Purpose: The aim was to identify the views of Australian and New Zealand health professionals regarding the support needs of people with head and neck cancer (HNC) and their families and current gaps in service delivery. Methods: A modified Delphi process assessed support needs of people with HNC following acute medical management. A systematic review of the literature was used to develop items relevant to seven key concepts underpinning the psychological experience of living with HNC. A panel of 105 health professionals was invited to participate in two questionnaire rounds. Results: Of the potential panellists, 50 (48%) completed round 1, and of these, 39 (78%) completed round 2. Following two rounds, there was consensus agreement on the concepts uncertainty and waiting, disruption to daily life and fear of recurrence. The concepts the diminished self, making sense of and managing the experience, sharing the burden and finding a path did not achieve consensus. There were no differences in responses according to gender, organization type or location. Medical professionals had significantly higher agreement for the concept uncertainty and waiting compared to allied health professionals, and professionals with five years’ or more experience had significantly higher agreement than those with less experience. Conclusions: Health professionals agreed that many psychosocial support needs of HNC survivors and families are not being met and that they experience difficulties in meeting these needs. Findings may inform evidence-based treatment programs for HNC survivors and their families to promote psychological resilience and quality of life in this vulnerable population