The effect of optometric treatment on asthenopia experienced by VDT operators

Seventy three VDT operators at an Oregon electronics firm were asked to rate their visual symptomology related to VDT use. Nearly 55% of the respondents were classified as symptomatic. Smyptomatic subjects were given complete visual examinations. Twelve of these participants were asked to rate the effectiveness of both nearpoint and farpoint lens prescriptions after wearing each set of lenses in the same frame for a period of 4 weeks each. An in-plant visual screening was performed and recommendations were made regarding the accuracy of various optometric tests in/predicting symptomatic VDT operators. Both near and far lens treatment were shown to significantly reduce visual symptomology. Individual case analysis suggests that if the farpoint refraction is similar to the patient\u27s habitual lenses, then nearpoint lenses may be warranted and preferred

Hypoglycaemia and hyperglycaemia are associated with unfavourable outcome in infants with hypoxic ischaemic encephalopathy: a post hoc analysis of the CoolCap Study

OBJECTIVE: To investigate the association of neonatal hypoglycaemia and hyperglycaemia with outcomes in infants with hypoxic ischaemic encephalopathy (HIE).DESIGN: Post hoc analysis of the CoolCap Study.SETTING: 25 perinatal centres in the UK, the USA and New Zealand during 1999-2002.PATIENTS: 234 infants at ≥36 weeks' gestation with moderate-to-severe HIE enrolled in the CoolCap Study. 214 (91%) infants had documented plasma glucose and follow-up outcome data.INTERVENTION: Infants were randomised to head cooling for 72 h starting within 6 h of birth, or standard care. Plasma glucose levels were measured at predetermined time intervals after randomisation.MAIN OUTCOME MEASURE: The unfavourable primary outcome of the study was death and/or severe neurodevelopmental disability at 18 months. Hypoglycaemia (≤40 mg/dL, ≤2.2 mmol/L) and hyperglycaemia (&gt;150 mg/dL, &gt;8.3 mmol/L) during the first 12 h after randomisation were investigated for univariable and multivariable associations with unfavourable primary outcome.RESULTS: 121 (57%) infants had abnormal plasma glucose values within 12 h of randomisation. Unfavourable outcome was observed in 126 (60%) infants and was more common among subjects with hypoglycaemia (81%, p=0.004), hyperglycaemia (67%, p=0.01) and any glucose derangement within the first 12 h (67%, p=0.002) compared with normoglycaemic infants (48%) in univariable analysis. These associations remained significant after adjusting for birth weight, Apgar score, pH, Sarnat stage and hypothermia therapy.CONCLUSIONS: Both hypoglycaemia and hyperglycaemia in infants with moderate-to-severe HIE were independently associated with unfavourable outcome. Future studies are needed to investigate the prognostic significance of these associations and their role as biomarkers of brain injury.TRIAL REGISTRATION NUMBER: (ClinicalTrials.gov NCT00383305).</p