Anterolateral extradural approach for C2-C3 disc herniation: technical case report

High cervical disc herniations (C2-C3) are extremely rare, and various approaches have been used to treat C2-C3. In this report, we recommend the anterolateral extradural approach as an alternative to treat C2-C3 disc herniation. A 72-year-old woman was referred to us with severe pain in the left side of her neck and occipital region. She had been taking high doses of analgesics but had no myelopathic symptoms. Magnetic resonance imaging of the cervical spine revealed that left paramedian, extruded C2-C3 disc material was compressing the spinal cord and the left C3 nerve root. A left-sided anterolateral extradural approach was done to remove the extruded disc material at the C2-C3 level. After resection of the transverse processes of C1 and C2, the V3 segment of the vertebral artery was mobilized posteromedially. The extruded disc material was carefully removed, and the vertebral artery was freed and repositioned. The anterolateral extradural approach to a C2-C3 disc herniation is a good alternative, especially in patients with thick or short necks.     

Effects of Different Doses of Caffeinated Coffee on Muscular Endurance,Cognitive Performance,and Cardiac Autonomic Modulation in Caffeine Naive Female Athletes

Caffeine is widely consumed among elite athletes for its well-known ergogenic properties, and its ability to increase exercise performance. However, studies to date have predominantly focused on the anhydrous form of caffeine in male participants. The aim of the study was to investigate the effect of caffeinated coffee ingestion on lower-upper body muscular endurance, cognitive performance, and heart rate variability (HRV) in female athletes. A total of 17 participants (mean ± standard deviation (SD): age = 23 ± 2 years, body mass = 64 ± 4 kg, height = 168 ± 3 cm) in a randomized cross-over design completed three testing sessions, following the ingestion of 3 mg/kg/bm of caffeine (3COF), 6 mg/kg/bm of caffeine (6COF) provided from coffee or decaffeinated coffee (PLA) in 600 mL of hot water. The testing results included: (1) repetition number for muscular endurance performance; (2): reaction time and response accuracy for cognitive performance; (3): HRV parameters, such as standard deviation of normal-to-normal (NN) intervals (SDNN), standard deviation of successive differences (SDSD), root mean square of successive differences (RMSSD), total power (TP), the ratio of low- and high-frequency powers (LF/HF), high-frequency power (HF), normalized HF (HFnu), low-frequency power (LF), and normalized LF (LFnu). A one-way repeated measures ANOVA revealed that 3COF (p = 0.024) and 6COF (p = 0.036) improved lower body muscular endurance in the first set as well as cognitive performance (p = 0.025, p = 0.035 in the post-test, respectively) compared to PLA. However, no differences were detected between trials for upper body muscular endurance (p = 0.07). Lastly, all HRV parameters did not change between trials (p > 0.05). In conclusion, ingesting caffeinated coffee improved lower body muscular endurance and cognitive performance, while not adversely affecting cardiac autonomic function.     

Comparison among Ocular Response Analyzer, Corvis ST and Goldmann applanation tonometry in healthy children

AIM: To explore the relationship between different parameters of Ocular Response Analyzer (ORA) and Corvis ST (CST) in a sample of healthy Iranian school-aged children and the relationship between parameters of these 2 instruments against intraocular pressure (IOP), measured by the Goldmann applanation tonometer (GAT-IOP), age and gender, and find possible correlation between ORA and CST with GAT. METHODS: This cross-sectional study included 90 healthy children. A general interview and complete eye examination were performed. Following successful GAT-IOP measurement, ORA and CST were conducted. The CST parameters were A 1/2 length (A1L, A2L), A 1/2 velocity (A1V, A2V), highest concavity deformation amplitude (HCDA), radius of curvature (RoC), peak distance (PD), central corneal thickness (CCT) and IOP. The ORA parameters were corneal hysteresis (CH), corneal resistance factor (CRF), Goldmann-correlated IOP (IOP-G) and corneal compensated IOP (IOP-CC). Extracted data was analyzed using the Statistical Package for Social Science software. RESULTS: Totally 39 males with age of 9.08±1.60 (6-12)y and 51 females with age of 8.96±1.55 (6-13)y were included. Many CST parameters were significantly correlated with CH, CRF, IOP-G and IOP-CC. Some CST parameters had a significant correlation with GAT-IOP, including IOP-CST in both eyes and HCDA, A2L, PD, and RoC in the left eye, but none with age, except A2L in the right eye. The CRF measurement showed a significant correlation with GAT-IOP in both eyes and CH in the right eye, yet, none with age. Among all CST and ORA parameters, CCT-CST in both eyes and A1L in right eye had a significant correlation with gender, although this was a negligible negative correlation. Comparison of mean IOP values by different devices showed a significantly highest IOP overestimation by CST and lowest by IOP-CC compared with GAT. Also, IOP-G versus IOP-CST significantly had the lowest IOP overestimation among others. Overall, either low positive correlation or negligible correlation was found between IOP measurements by 3 instruments. CONCLUSION: The study finds the highest IOP overestimation by CST and lowest by IOP-CC compared with GAT. Overall, either low positive correlation or negligible correlation is found between IOP measurements by the 3 instruments.     

Passive smoking and nasopharyngeal colonization by <Emphasis Type="Italic">Streptococcus pneumoniae</Emphasis>, <Emphasis Type="Italic">Haemophilus influenzae</Emphasis>, and <Emphasis Type="Italic">Moraxella catarrhalis</Emphasis> in daycare children

Exposure to tobacco smoke may be associated with higher risk of nasopharyngeal colonization and infection by Streptococcus pneumoniae (SP), Haemophilus influenzae (HI), and Moraxella catarrhalis (MC). This study was done to determine the influence of passive smoking on S. pneumoniae, H. influenzae, and M. catarrhalis colonization rates among children. This is a prospective cross-sectional study. Tertiary referral centers with accredited otorhinolaryngology-head and neck surgery and Microbiology Departments. In this cross-sectional study, 2–6 years old children in 10 randomly selected day-care centers in northeast of Iran (Mashad) were studied. Smoking exposure and medical history were recorded. Carriage rates for aforementioned bacteria were analyzed on the basis of smoking exposure. 1,125 children (Female/Male: 597/528) with the mean age of 5.05 ± 0.98 years were studied. Carriage rates of S. pneumoniae, H. influenzae and M. catarrhalis among children were 10.1, 8.8 and 6.7%, respectively. Mixed colonization was found in 2.7%. There was a significant difference in carriage rates between children who live in smoking families compare to those with nonsmoking families for M. catarrhalis (P = 0.001) but not for S. pneumoniae, and H. influenza (P = 0.798 and P = 0.117, respectively). It seems exposure to tobacco smoke is associated with increased carriage rate of M. catarrhalis in day-care children.