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Postoperative outpatient rehabilitation with balance training improves the balance, mobility, and functional outcomes in patients with knee osteoarthritis after total knee replacement.

LHIDLongitudinal Health Insurance Data AIM The aim of the study was to investigate the risk of stroke in patients with cerebral palsy (CP), based on nationwide data in Taiwan. RESULTS Patients with CP were more likely to suffer stroke than the comparison population, after adjusting for potential confounding factors (adjusted hazard ratio: 2.17; 95% confidence interval [CI]: 1.74-2.69). The hazard ratio of stroke was 4.78 (95% CI: 3.18-7.17) and 1.57 (95% CI: 1.20-2.05) for patients with CP aged 50 years and under, and over 50 years respectively. METHODINTERPRETATION Cerebral palsy is a risk factor or marker for stroke that is independent of traditional stroke risk factors. Further research in this area is warranted.Cerebral palsy (CP) is defined as a group of permanent disorders of the development of movement and posture, which causes activity limitation, and is attributed to nonprogressive disturbances that occur in the developing fetal or infant brain. 1 Clinical manifestations include motor deficits, perceptive disturbances, cognitive impairment, and behavioural and emotional disorders.1 A common classification is based on abnormal muscle tone, including spastic, dyskinetic, and ataxic types.1 The worldwide prevalence of CP is 2.0 to 2.5 per 1000 live births.2 The precise aetiology of CP remains unknown, but preterm birth is considered to be a major risk factor.3 Cerebral palsy can be a severe neurological disability that disturbs movement, posture, neuromuscular control, and often results in dysphagia, epilepsy, and osteoporosis.According to the latest data released by the Center for Disease Control and Prevention's National Center for Health Statistics, stroke was the fourth leading cause of death in the United States in 2008. In Taiwan, stroke was the third major cause of death in 2010, and accounted for 7% of total deaths that year. It places an enormous cost and burden on Taiwan's national health care system. 4 One community-based Taiwanese cohort study reported that the incidence of stroke for people aged over 35 years was 3.32 per 1000 for males and 4.67 per 1000 for females. 5There are well-known risk factors for stroke such as hypertension, diabetes, hyperlipidaemia, smoking, obesity, and urbanization level.6 Some evidence supports the theory that inflammation and chronic infection may also play an essential role in stroke.7 A previous study showed that the death rates for cerebrovascular disease were three times as high in the CP population compared with the general population.8 Studies regarding the relationship between CP and stroke have not yet been explored thoroughly. To our knowledge, no previous study with large patient samples has been conducted to evaluate the risk of stroke in patients with CP. The purpose of the current study was to assess the hypothesis that CP is a risk factor for stroke by using a large-scale nationwide Taiwanese database. METHOD Study participants and designThis is a prospective matched cohort study. The data used in this study were obtained from the Longitudinal Heal...

A prospective study of 84 consecutive patients undergoing penetrating keratoplasty over a 6-month interval was performed to identify risk factors for postoperative epithelial defects. Data collected included donor age, host age, time postmortem until enucleation, general health of donor and host, any history of glaucoma, any surgical procedure, the indication for penetrating keratoplasty, and the presence of any epithelial defect preoperatively in the donor. Patients were evaluated 1 day postoperatively for any epithelial defects greater than 1 mm2 central to the sutures. Single-variable associations and multiple stepwise logistic regression using standard biostatistical techniques were performed. Thirty-one percent (26 of 84) of the patients had epithelial defects on the first postoperative day. Only diabetes in the donor (P = .03) and longer death-toenucleation times (P = .03) were associated with an increased risk of epithelial defects. We conclude that diabetes in the donor and longer death-to-enucleation times predispose to epithelial defects after penetrating keratoplasty.