Correlation of cephalic anthropometric parameters and microsurgical anatomy of the optic nerves: a cadaveric morphometric study

BACKGROUND: This study was designed to elucidate the possible correlation of cranial anthropometric measurements with the chiasm to limbus sphenoidale distance to facilitate preoperative estimation of this distance and to choose a better surgical approach. METHODS: Thirty-three fresh adult cadaver heads (22 males and 11 females) were evaluated for cranial anthropometric measurements. The precraniotomy anthropometric measurements included (A) inion to nasion distance and (B) the longest intermeatal meridian. Subsequently, with a standard craniotomy, the following intervals were measured: (C) optic chiasm to falciform ligament, (D) anterior aspect of optic chiasm to limbus sphenoidale, and (E) limbus sphenoidale to inner nasion. A combined ratio parameter, labeled as (F), was calculated from the following equation: F = B/E x 10. RESULTS: The mean values and standard errors of the mean of parameters A to F were 195.8 +/- 14.53 mm, 374.7 +/- 25.29 mm, 10.47 +/- 1.89 mm, 9.93 +/- 2.01 mm, 38.46 +/- 3.17 mm, and 9.81 +/- 1.11, respectively. The parameter D had significant correlation to the parameters B, C, E, and F. The most significant correlation was seen between parameters D and F (p < 0.001). According to linear regression assessment between parameters D and F, the following regression equation was obtained: D = 4.24 + 0.58F. CONCLUSIONS: Optic nerve topography and dimensions show inter-personal variations that may be anticipated to some extent with cranial anthropometric data. Calculating of F ratio gives us an acceptable estimation of the actual distance of chiasm to limbus sphenoidale, which in turn can help the surgeon to select the approach to tumors of intrasellar region. However, the role of meticulous imaging studies cannot be overemphasized to confirm the anticipated estimations.     

Immune checkpoint inhibitor-induced inflammatory arthritis: identification and management

ABSTRACT

Introduction

Immune checkpoint inhibitors (ICIs) have proved to be groundbreaking in the field of oncology. However, immune system overactivation from ICIs has introduced a novel medical entity known as immune-related adverse events (irAEs), that can affect any organ or tissue. ICI-induced inflammatory arthritis (ICI-IIA) is the most common musculoskeletal irAE and can lead to significant morbidity and limitation in anti-cancer therapy.     

Effectiveness of telephone-based screening and triage during COVID-19 outbreak in the promoted primary healthcare system: a case study in Ardabil province,Iran

Journal of Public Health - Screening services for early detection of patients is one of the important capabilities of the health system with a proper referral system. In the crisis of respiratory...     

Does the rate of inappropriate therapy differ in implantable cardioverter–defibrillators from different manufacturers?

Objective We conducted this study to compare the rate of ≥1 inappropriate therapy between ICDs from two manufacturers which use different discriminatory protocols. Method One hundred sixty two patients (mean age 58 ± 13 years, 126 male) who received ICDs between January 2001 and 2005 were included in the study. Clinical, electrocardiographic, and ICD stored data and electrograms were collected and analyzed. Immediately after implantation all the detection and discrimination criteria were activated with the nominal values in order to compare the two discriminatory protocols under the default manufacturer’s settings. Results During the follow up period of 14.3 ± 10 months, 49 (30%) patients received ≥1 inappropriate ICD therapy. The rate of ≥1 inappropriate ICD therapy in manufacturer A and B ICDs was 26% (n = 29) and 41% (n = 20), respectively. Comparing the rate of ≥1 inappropriate ICD therapy between the two groups by Kaplan–Meier analysis and the log rank test resulted in P = 0.04. Conclusion Having all discriminatory variables activated with the nominal values, discriminatory performance differs between the two manufacturers. Further larger-scale studies are warranted to prospectively compare the performance of various available ICDs’ discriminatory protocols, and define the optimum combination of discriminators in each ICD to decrease the rate of inappropriate therapy.     

Dopamine protects gentamicin early induced nephrotoxicity in Sprague–Dawley rats

Routine therapeutic use of dopamine has been shown to influence renal hemodynamic response through removing contractile effects of nephrotoxicants on mesangial cells and subsequent interaction with locally expressed prostaglandin subtypes (PGE2 and PGI2). To determine the way in which the amino acid managed to preserve Sprague–Dawley rats against gentamicin-induced nephrotoxicity, a randomized prospective study was carried out. In this study, 40 healthy rats were randomly assigned in four trials to receive either normal saline, gentamicin, gentamicin plus dopamine, or dopamine for 9 days. Administration of gentamicin at a dose of 80 mg kg⁻¹ day⁻¹ reduced the creatinine clearance as result of early hemodynamic toxicity, and tubular reabsorption of electrolytes after phospholipiduria and urinary activity of tubular enzymes. H&E histopathology revealed acute tubular necrosis with cast formation triggered by gentamicin over 9 days of experiment, in addition to interstitial nephritis and tubular epithelial loss. Further biochemical studies showed protecting effects of supplemented dopamine, including slow down in the urinary enzyme activity, modest to moderate phospholipiduria with recovery in the renal clearance and the ATPase activity up to 50% when compared to saline- and gentamicin-treated rats. Normal glomerular and tubular function on recovery from toxic renal failure led us to conclude that renovascular effects of dopamine were early attributed to glomerular preservation, whereas the tubule function prepared by the amino acid was just a consequent.     

Evidence-Based Framework to Manage Cyanobacteria and Cyanotoxins in Water and Sludge from Drinking Water Treatment Plants

Freshwater bodies and, consequently, drinking water treatment plants (DWTPs) sources are increasingly facing toxic cyanobacterial blooms. Even though conventional treatment processes including coagulation, flocculation, sedimentation, and filtration can control cyanobacteria and cell-bound cyanotoxins, these processes may encounter challenges such as inefficient removal of dissolved metabolites and cyanobacterial cell breakthrough. Furthermore, conventional treatment processes may lead to the accumulation of cyanobacteria cells and cyanotoxins in sludge. Pre-oxidation can enhance coagulation efficiency as it provides the first barrier against cyanobacteria and cyanotoxins and it decreases cell accumulation in DWTP sludge. This critical review aims to: (i) evaluate the state of the science of cyanobacteria and cyanotoxin management throughout DWTPs, as well as their associated sludge, and (ii) develop a decision framework to manage cyanobacteria and cyanotoxins in DWTPs and sludge. The review identified that lab-cultured-based pre-oxidation studies may not represent the real bloom pre-oxidation efficacy. Moreover, the application of a common exposure unit CT (residual concentration × contact time) provides a proper understanding of cyanobacteria pre-oxidation efficiency. Recently, reported challenges on cyanobacterial survival and growth in sludge alongside the cell lysis and cyanotoxin release raised health and technical concerns with regards to sludge storage and sludge supernatant recycling to the head of DWTPs. According to the review, oxidation has not been identified as a feasible option to handle cyanobacterial-laden sludge due to low cell and cyanotoxin removal efficacy. Based on the reviewed literature, a decision framework is proposed to manage cyanobacteria and cyanotoxins and their associated sludge in DWTPs.     

Risk:benefit ratio of nonsteroidal anti-inflammatory drugs in systemic lupus erythematosus

Nearly 80% of patients with systemic lupus erythematosus (SLE) are treated with NSAIDs for fever, arthritis, serositis and headaches. This article reviews currently available literature on non-selective and selective inhibitors of cyclooxygenases, with an emphasis on the efficacy and safety profile reported in SLE patients. All NSAIDs, regardless of their cyclooxygenase selectivity, induced renal side effects including sodium retention and reduction in glomerular filtration rate. In addition, lupus nephritis is a risk factor for NSAID-induced acute renal failure. NSAID-induced hepatotoxicity is increased in SLE patients in addition to cutaneous and allergic reactions. Finally, aseptic meningitis has been reported more frequently in NSAID-treated SLE patients. Nevertheless, NSAIDs can safely be prescribed to most lupus patients provided that their administration is re-evaluated on a regular basis and the patient is closely monitored.