Intraoperative mitomycin C in the treatment of pterygium

PURPOSE: To evaluate the effectiveness of intraoperative mitomycin C in preventing the recurrence of primary pterygium. METHODS: In this prospective, randomized study, 38 eyes of 35 patients with primary pterygium were evaluated. In 19 eyes, the "bare sclera technique" combined with intraoperative application of 0.2 mg/mL (0.02%) mitomycin C for five minutes was performed (mitomycin C treated group). The other 19 eyes--taken as control group--underwent surgical excision alone. Statistics were analyzed using the Mann-Whitney U test and the Fischer's exact test. RESULTS: Patients were 20-38 years of age. The mean age was 25.29 +/- 5.08 in the mitomycin C treated group and 25.00 +/- 5.19 in the control group. During the mean follow-up of 17.04 months (range, 12-36 months; SD = 5.89), 4 recurrences (21%) were observed in the mitomycin C treated group and 11 (57.8%) in the control group. The difference between the two groups was significant (p = 0.045). No postoperative complication was encountered in both groups except for recurrences. CONCLUSION: Intraoperative mitomycin C was found to be effective in preventing the recurrence of primary pterygium.     

The effect of tianeptine in the prevention of radiation-induced neurocognitive impairment

Radiation-induced neurocognitive impairment is an undesirable radiation-induced toxicity and a common health problem in patients with primary or metastatic brain tumor. It greatly impairs quality of life for long-term brain tumor survivors. Hippocampus is the most important brain structure for neurocognitive functions. It has been shown that radiation affects the hippocampal neurogenesis due to either induce the apoptosis or reduce the precursor cell proliferation in the hippocampus. Radiation-induced microglial inflammatory response is also negative regulator of neurogenesis. Tianeptine is a clinically effective antidepressant that induces neurogenesis. It has also been shown that tianeptine is able to reduce apoptosis and cytoprotective against the effects of proinflammatory cytokines in the hippocampus. Given the putative role of impaired hippocampal neurogenesis in radiation-induced neurocognitive impairment we think that tianeptine can be effective for preventing radiation-induced neurocognitive impairment by increasing hippocampal neurogenesis.     

Risk of anastomotic leakage with nonsteroidal anti-inflammatory drugs within an enhanced recovery program

Introduction

Anastomotic leakage is a serious complication after colorectal resection. Recent studies suggest that nonsteroidal anti-inflammatory drugs may increase the risk of anastomotic leakage. We investigated this association in our enhanced recovery population.

Material and Methods

Patients undergoing an elective colon or rectal resection with primary anastomosis because of malignancy and treated within our enhanced recovery program were included. Univariable and multivariable logistic regression analyses were used to study risk factors for anastomotic leakage.

Results

Between 2006 and 2013, 856 patients were included. The anastomotic leakage rate was significantly higher in the group that received nonsteroidal anti-inflammatory drugs compared to patients who did not: 9.2 vs. 5.3 %, p?=?0.038. This higher rate was only seen in patients receiving diclofenac: for colonic resections, 11.8 vs. 6.0 %, p?=?0.016; for rectal resections, 13.1 vs. 0 %, p?=?0.017. Only male sex (odds ratio 2.20, p?=?0.005) was also independently associated with anastomotic leakage.

Conclusion

The results of this study are in line with other comparable studies in the literature, showing an increased risk for anastomotic leakage with diclofenac. The use of diclofenac in colorectal surgery can no longer be recommended. Alternatives for postoperative analgesia need to be explored within an enhanced recovery program.

     

DIURNAL INTRAOCULAR PRESSURE VARIATION IN PSEUDOEXFOLIATION SYNDROME

Purpose: To describe and compare the diurnal intraocular pressure (IOP) variation in patients with pseudoexfoliation syndrome (PXS) and normal subjects. Methods: We prospectively investigated 20 PXS patients (11 bilateral and 9 unilateral) and age and sex matched 25 normal subjects. Both eyes of the bilat-     

A man with a big tumour on his back

A 47-year-old man was seen with a big tumour on his back. The tumour had started growing a year earlier, but the man never consulted a doctor. Histopathology showed melanoma, and there were no signs of metastastatic disease. The tumour was surgically removed.