Comparative results of trepanotrabeculectomy and iridencleisis in primary glaucoma]

For the last 10 years 500 iridencleisis and 250 trepanotrabeculectomies were performed. For this study are subjected only 205 cases of basal and total iridencleisis and 100 cases of trepanotrabeculectomy, performed in chronic open and chronic closed angle glaucoma. The authors point out that some common factors play the role on the final results, independently of the type of the operation. It was observed that the results were worse in patients having the diabetes and/or arterial hypertension, when the operation is performed in the advanced age or in the late stage of glaucoma, and also if the eye was already operated. To evaluate the result of the operations (basal and total iridencleisis, trepanotrabeculectomy) the authors estimate that is not enough to take the intraocular tension as the unic parameter, one should take in consideration also the visual field, visual acuity and also the state of the optic disc in the follow-up period (see Tbl. 4). This period should not be shorter than one year. With the trepanotrabeculectomy (85%) and with total iridencleisis (86,5%) the intraocular tensions could be normalised in the higher percentage than with the basal iridencleisis (75,5%). On the other hand, if one take also the other parameters for the evaluation (visual field, visual acuity, status of the optic disc) one could conclude that the best result was achieved with trepanotrabeculectomy (80% the complete consolidation), and than with total iridencleisis (69,4%) or basal iridencleisis (67%). In trepanotrabeculectomy the peroperative and postoperative complications are rare.     

Neutralization of macrophage migration inhibitory factor-novel approach for the treatment of immunoinflammatory disorders

Macrophage migration inhibitory factor (MIF) is a pro-inflammatory cytokine that plays an important role in the pathogenesis of numerous inflammatory and autoimmune disorders. As such, it is an attractive therapeutic target for the treatment of these disorders. Several groups of possible MIF inhibitors have so far been identified, including anti-MIF antibodies, small chemical compounds and plant-derived inhibitors. This review presents current understanding of the effects of MIF neutralization in a number of experimental animal models of inflammatory and autoimmune diseases and discusses the potential problems in translating this kind of therapy into human subjects.     

Modulation of corticomuscular coherence by peripheral stimuli

The purpose of this study was to investigate the effects of peripheral afferent stimuli on the synchrony between brain and muscle activity as estimated by corticomuscular coherence (CMC). Electroencephalogram (EEG) from sensorimotor cortex and electromyogram (EMG) from two intrinsic hand muscles were recorded during a key grip motor task, and the modulation of CMC caused by afferent electrical and mechanical stimulation was measured. The particular stimuli used were graded single-pulse electrical stimuli, above threshold for perception and activating cutaneous afferents, applied to the dominant or non-dominant index finger, and a pulsed mechanical displacement of the gripped object causing the subject to feel as if the object may be dropped. Following electrical stimulation of the dominant index finger, the level of β-range (14–36 Hz) CMC was reduced in a stimulus intensity-dependent fashion for up to 400 ms post-stimulus, then returned with greater magnitude before falling to baseline levels over 2.5 s, outlasting the reflex and evoked changes in EMG and EEG. Subjects showing no baseline β-range CMC nevertheless showed post-stimulus increases in β-range CMC with the same time course as those with baseline β-range CMC. The mechanical stimuli produced similar modulation of β-range CMC. Electrical stimuli to the non-dominant index finger produced no significant increase in β-range CMC. The results suggest that both cutaneous and proprioceptive afferents have access to circuits generating CMC, but that only a functionally relevant stimulus produces significant modulation of the background β-range CMC, providing further evidence that β-range CMC has an important role in sensorimotor integration.     

Clinical Pharmacokinetics of Tacrolimus after the First Oral Administration in Renal Transplant Recipients on Triple Immunosuppressive Therapy

Abstract: Monitoring of tacrolimus blood concentration is of utmost importance in the management of renal transplant recipients because of Narrow Therapeutic Index and highly variable pharmacokinetics. The aim of this study was to detect inter‐patient pharmacokinetic variability of tacrolimus and to assess the predictability of individual tacrolimus concentrations at various times of the area under the curve (AUC) seeking to find the best sampling time to predict the exposure of tacrolimus in renal transplant recipients with triple therapy. This oral dose tacrolimus pharmacokinetics study was conducted in 18 Serbian renal transplant recipients on triple immunosuppressive therapy, including basiliximab. The first oral dose of tacrolimus (0.05 mg/kg) was given on day 5 post‐transplant; blood concentration was measured by microparticle enzyme immunoassay method. Associations between each sampling time‐point of concentrations and AUC₁₂ were evaluated by Pearson correlation coefficients. Abbreviated sampling equations were derived by multiple, stepwise regression analyses. The variance in the strength of association between predicted AUC (AUC_p) and AUC₁₂ was reflected by linear regression coefficients. AUC₁₂ showed remarkable inter‐individual variations after the first oral dose of tacrolimus. The area of the maximum AUC was four times higher than that of the minimum AUC. C₄ seems to be an indicator of total body exposure to tacrolimus. Alternatively, the concentrations at 1.5, 4 and 8 hr as an abbreviated AUC were as good a predictor as a full pharmacokinetic study. Our results show a significant difference between men and women. A three‐point sampling method seemed to be the best abbreviated AUC for a cost‐effective tacrolimus monitoring strategy.     

Dashboard (in the) Knee

We present the case of a 19-year-old individual presenting to an orthopaedic outpatient clinic several months following a dashboard knee injury during a road traffic accident with intermittent mechanical symptoms. Despite unremarkable examination findings and normal magnetic resonance imaging, the patient was identified subsequently as having an intra-articular plastic foreign body consistent with a piece of dashboard on arthroscopic knee assessment, the retrieval of which resulted in a complete resolution of symptoms.