Relation of albumin/creatinine ratio to C-reactive protein and to the metabolic syndrome

We hypothesized that the association of high sensitivity C-reactive protein (CRP) with urinary albumin excretion (UAE) is predominately mediated through its correlation with the metabolic syndrome. Serum CRP and urine albumin:creatinine ratios (ACR) from 720 preventive cardiology patients were analyzed to estimate age- and gender-adjusted relative risk of high CRP and metabolic syndrome for high ACR. These data demonstrate that CRP independently predicts the presence of UAE, a marker of endothelial dysfunction.     

Ninth cranial nerve stimulation for epilepsy control. Part 2: surgical feasibility in humans

OBJECTIVE: To determine the anatomical and surgical feasibility of placement of a stimulator around the nerve of Hering (HN; a branch of cranial nerve nine). We previously determined the success of HN stimulation in controlling epileptiform activity in a canine model study. The present study assessed the ability to extrapolate the ease of surgical dissection and surrounding anatomy to humans. METHODS: Fifteen human cadavers (8 male, 7 female) were studied. The HN on each side was specifically evaluated in each specimen with respect to its presence, size, surgically accessible length below the mandibular angle, relationship to the internal carotid artery (ICA) and carotid bifurcation and relation to the common facial vein (CFV), thyroid cartilage (superior edge) and superior cervical ganglion (SCG). RESULTS: All 15 cadavers exhibited specimens of HN bilaterally, with the nerve diameter ranging from 0.5 to 1.5 mm (mean 1.0 mm); in relation to the ICA, the HN coursed anteromedially in 60%, anteriorly in 33% and anterolaterally in 7% of cases, and appeared to distinctly emerge at the level of the carotid bifurcation in all specimens. The surgically accessible length below the mandibular angle ranged from 6 to 30 mm (mean 15 mm). Relative to the carotid bifurcation, the superior edge of the thyroid cartilage was -35 to 33 mm (mean -5.4 mm) above; the CFV, which was clearly identifiable in only two thirds of the specimens, was -10 to 15 mm (mean 3.0 mm) above; and the inferiormost portion of the SCG was 6-30 mm (mean 16.6 mm) above. CONCLUSION: This study indicates that the HN was clearly present and surgically accessible in all human specimens. Based on the present study and our previous canine study, HN stimulation could be an important therapy for medically intractable epilepsy.     

Infectious markers in blood donors of East Delhi: prevalence and trends

All blood donors Voluntary and Replacement who have donated blood in the centre or in the voluntary blood donation camps, were analyzed for the prevalence of infectious markers over a period of 3 years from 1997 to 1999. A total of 52500 blood units were collected and screened for hepatitis B surface antigen (HBsAg), antibodies to HIV I and II and VDRL reactivity. Seropositivity was 471 (0.8%) for HIV I and II, 963 (1.8%) for HbsAg, 1449 (2.76%) for VDRL and 64 (0.5%) for anti HCV. Voluntary donors were comparatively safe. The seropositivity for HIV showed increasing trend between 1997 to 1999.     

Metallic microbeads for hair extensions: Hidden dangers for magnetic resonance imaging

Metallic foreign objects can cause various thermal injuries in patients undergoing magnetic resonance imaging (MRI). We present a case of a 33-year-old woman with numerous metallic microbeads on her head used for attaching hair extensions, who required MRI of her cervical spine under anesthesia. Due to the nature of how these microbeads were attached, as well as the quantity and configuration, these objects were determined to be a significant risk, especially for a patient requiring anesthesia for their scan. To our knowledge, this is the first report in literature of a patient presenting with such objects for MRI. Awareness of the implications of these microbeads on patient safety and recognizing the importance of a thorough safety screening process can enhance care for patients requiring MRI.