Intraocular pressure in infants and its association with hormonal changes with vaginal birth versus cesarean section

To investigate cord arterial blood sample and the relationship between birth stress and intraocular pressure in infants at 5 min after delivery. The IOP measurements were taken using Tonopen-Avia tonometer to 158 newborns (158 eyes) at 5th min after birth, in a university hospital. Cord blood was collected within 3 min after delivery. Intraocular pressure, gender, gestation period, mode of delivery, and birth weight of newborns were noted from medical records. Sixty-two babies were delivered by normal vaginal delivery (NVD) and 96 by cesarian section (C/S). Mean IOP of NVD and C/S groups were 19.56 ± 3.84 and 17.42 ± 3.50, respectively. There was significant difference of mean IOP between two groups. (p < 0.001) There were significant differences between two groups regarding APGAR score (p < 0.001) and cord blood adrenaline (p = 0.003), noradrenaline (p = 0.008), and cortisol (p < 0.001) levels. There was no difference between infant corneal thickness measurements (p = 0.698). In correlation analyses, there is a strong negative correlation between the labor type and postpartum measurements except corneal thickness. Correlation analyses of the 5th min intraocular pressure of the groups individually revealed significant correlation in the NVD group. The conclusion is that the intraocular pressure of newborn infants was higher in NVD delivery compare to C/S. Blood hormonal changes in different anesthesia types and physical stress was thought as the main reason of this result.     

Correlation between visual function and refractive, topographic, pachymetric and aberrometric data in eyes with keratoconus

AIM: To analyze the relationship between two visual functions and refractive, topographic, pachymetric and aberrometric indicators in eyes with keratoconus. METHODS: Corrected distance visual acuity (CDVA), and letter contrast sensitivity (CS) were correlated with refraction, corneal topography, pachymetry, and total corneal wavefront data prospectively in 71 eyes with keratoconus. The topographic indices assessed were simulated keratometry for the flattest and steepest meridians (SimK1 and SimK2), posterior steeper K (Ks), elevation value in best-fit sphere (BFS) maps, squared eccentricity (?2), aspheric asymmetric index (AAI), pachymetry, thickness progression index (TPI), the amount of pachymetric decentralization (APD), and GalileiTM-keratoconus indices. RESULTS: The mean CDVA (expressed as logMAR) were 0.25±0.21. The mean CS was 1.25±0.46. The spherical refraction correlated well with CDVA (r=-0.526, P<0.001). From topographic indices, SRI correlated with CS (r=-0.695), and IAI with CS (r=-0.672) (P<0.001 for all). Root mean square (RMS) was 4.3±1.81 µm, spherical aberration (SA) was -0.4±0.67 µm, vertical and horizontal coma were -2.1±1.47 and -0.4±0.72 µm. All wavefront data (except horizontal coma), AAI, ?2 and maximum BFS correlated significantly with the visual function (P≤0.001 for all). CONCLUSION: In this study, CS is more affected than CDVA as a visual function. The quantity and quality of vision is significantly correlated with well-known and new topographic indices. There is not a significant correlation between visual function and pachymetric parameters. The significantly correlated indices can be used in staging keratoconus and to follow the outcome of a treatment.     

Antitumoral and antioxidant effects of a hydroalcoholic extract of cat's claw (Uncaria tomentosa) (Willd. Ex Roem. & Schult) in an in vivo carcinosarcoma model

Aim of the study

The present work intended to study the antitumoral and antioxidant effects of Uncaria tomentosa (UT) hydroalcoholic extract in the Walker-256 cancer model.

Methods and materials

Walker-256 cells were subcutaneously inoculated in the pelvic limb of male Wistar rats. Daily gavage with UT extract (10, 50 or 100 mg kg⁻¹, Groups UT) or saline solution (Control, Group C) was subsequently initiated, until 14 days afterwards. For some parameters, a group of healthy rats (Baseline, Group B) was added. At the end of treatment the following parameters were evaluated: (a) tumor volume and mass; (b) plasmatic concentration of urea, alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyltransferase (GGT) and lactate dehydrogenase (LDH); (c) hepatic and tumoral activity of catalase (CAT) and superoxide dismutase (SOD), as well as the rate of lipid peroxidation (LPO) and gluthatione (GSH); and (d) hepatic glutathione-S-transferase (GST) activity. The reactivity of UT extract with the stable free radical 2,2-diphenyl-1-picrylhydrazyl (DPPH) was assessed in parallel.

Results

UT hydroalcoholic extract successfully reduced the tumor growth. In addition, treatment with UT reduced the activity of AST, which had been increased as a result of tumor inoculation, thus attempting to return it to normal levels. UT did not reverse the increase of LDH and GGT plasma levels, although all doses were remarkably effective in reducing urea plasma levels. An important in vitro free radical-scavenging activity was detected at various concentrations of UT extract (1–300 μg mL⁻¹). Treatment also resulted in increased CAT activity in liver, while decreasing it in tumor tissue. SOD activity was reduced in liver as well as in tumor, compared to Group C. No statistical significance concerning ALT, GST, LPO or GSH were observed.

Conclusions

This data represent an in vivo demonstration of both antitumoral and antioxidant effects of UT hydroalcoholic extract. The antineoplastic activity may result, partially at least, from the ability of UT to regulate redox and metabolism homeostasis.     

Sonic Hedgehog Agonist Protects Against Complex Neonatal Cerebellar Injury

The cerebellum undergoes rapid growth during the third trimester and is vulnerable to injury and deficient growth in infants born prematurely. Factors associated with preterm cerebellar hypoplasia include chronic lung disease and postnatal glucocorticoid administration. We modeled chronic hypoxemia and glucocorticoid administration in neonatal mice to study whole cerebellar and cell type-specific effects of dual exposure. Chronic neonatal hypoxia resulted in permanent cerebellar hypoplasia. This was compounded by administration of prednisolone as shown by greater volume loss and Purkinje cell death. In the setting of hypoxia and prednisolone, administration of a small molecule Smoothened-Hedgehog agonist (SAG) preserved cerebellar volume and protected against Purkinje cell death. Such protective effects were observed even when SAG was given as a one-time dose after dual insult. To model complex injury and determine cell type-specific roles for the hypoxia inducible factor (HIF) pathway, we performed conditional knockout of von Hippel Lindau (VHL) to hyperactivate HIF1α in cerebellar granule neuron precursors (CGNP) or Purkinje cells. Surprisingly, HIF activation in either cell type resulted in no cerebellar deficit. However, in mice administered prednisolone, HIF overactivation in CGNPs resulted in significant cerebellar hypoplasia, whereas HIF overactivation in Purkinje cells caused cell death. Together, these findings indicate that HIF primes both cell types for injury via glucocorticoids, and that hypoxia/HIF + postnatal glucocorticoid administration act on distinct cellular pathways to cause cerebellar injury. They further suggest that SAG is neuroprotective in the setting of complex neonatal cerebellar injury.     

Does delay of adjuvant chemotherapy impact survival in patients with resected stage II and III colon adenocarcinoma?

BACKGROUND:

It is unclear whether delays in commencing adjuvant chemotherapy after surgical resection of colon adenocarcinoma adversely impact survival.

METHODS:

Patients with stage II‐III colon adenocarcinoma who received adjuvant chemotherapy at 2 centers were identified through the institutional tumor registry. Time to adjuvant chemotherapy, overall survival (OS), and relapse‐free survival (RFS) were calculated from the day of surgery. Patients were dichotomized into early (time to adjuvant chemotherapy ≤60 days) and late treatment (time to adjuvant chemotherapy >60 days) groups. OS and RFS were compared using log‐rank test and multivariate analysis by the Cox proportional hazards model.

RESULTS:

Of 186 patients included in the study, 49 (26%) had received adjuvant chemotherapy >60 days after surgical resection. Thirty percent of the delays were system related (eg, late referrals, insurance authorizations). Time to adjuvant chemotherapy >60 days was associated with significantly worse OS in both univariate analysis and a Cox proportional hazards model (hazard ratio, 2.17; 95% confidence interval, 1.08‐4.36). Although difference in RFS between the 2 groups favored time to adjuvant chemotherapy <60, this did not reach statistical significance.

CONCLUSIONS:

Adjuvant chemotherapy delay >60 days after surgical resection of colon cancer is associated with worse OS. Cancer 2011;. © 2010 American Cancer Society.     

Effect of nasal mometasone furoate on the nasal and nasopharyngeal flora

Objective

Mometasone furoate (MF) is one of the commonly used topical steroids, particularly for patients with allergic rhinitis. However, its effect on the colonization of bacteria that may cause superinfections by suppressing the local immunity is not known. Thus, we investigated the effect of MF use on the nasal and nasopharyngeal microbial flora.

Materials and methods

Swab samples were taken from 35 patients who required MF monotherapy, just before and after one month of the treatment. Samples were maintained in Stuart's medium. Each swab was transferred to 1 ml of a sterile saline solution, then into the standard agar. After incubation under 5% carbon dioxide at 37 °C, colony number was detected per ml.

Results

Colony counts of nasal or nasopharyngeal microbial flora did not show any statistically significant alteration with one month use of MF. However, an increase in potential pathogens as well as normal flora bacteria was determined in five of the patients and six patients acquired new nasopharyngeal potential pathogens, mostly Moraxella catarrhalis, Pseudomonas aeruginosa and Staphylococcus aureus, following the use of MF.

Conclusion

The use of MF for one month did not statistically significantly change the nasal and nasopharyngeal flora. This study indicates that MF could be increase the colonization of the potential pathogens in some of the patients at the subclinical level particularly in the nasopharyngeal area.     

Annular Plaques on the Tongue: What Is Your Diagnosis?

Geographic tongue is an inflammatory disorder of the tongue characterized by asymptomatic erythematous patches with serpiginous borders. Candidiasis of the tongue may be confused with geographic tongue. A 63-year-old male patient with painful white annular lesions localized to the left side of his tongue is presented. He applied topical corticosteroid and antiinflammatory agents, but his lesions did not respond to those therapies. Using direct mycologic examination and culture, the patient was diagnosed with candidiasis. After systemic and topical antifungal therapy, clinical improvement was observed. With this case, the clinical forms of oral candidiasis were discussed, and it was suggested that the clinical presentation of mucosal candidiasis may vary according to the stage of infection and individual immunity.     

An international serotype 3 clone causing pediatric noninvasive infections in Israel, Costa Rica, and Lithuania

BACKGROUND: Serotype 3 is known for its ability to cause invasive diseases worldwide. In the United States, after introduction of the 7-valent pneumococcal conjugate vaccine (PCV7), the prevalence of a serotype 3 clone (Netherlands-31/ST180) increased. The present study was aimed to evaluate the importance of serotype 3 clones in noninvasive infections in Israel, Costa Rica, and Lithuania. METHODS: Molecular typing and antibiotic resistance were performed on 77 serotype 3 strains recovered from pediatric noninvasive infections during 2003-2005, and on 50 carried strains from healthy carriers. RESULTS: Serotype 3 ranked second among isolates from noninvasive infections in Costa Rica and Lithuania, and seventh among the Israeli isolates. Pulsed field gel electrophoresis (PFGE) analysis revealed the presence of 1 major cluster (64/77, 83%); this cluster comprised 60/64 fully susceptible strains that corresponded to the Netherlands-31/ST180 clone, and 4/64 multidrug-resistant strains, all from Lithuania, that corresponded to ST505, a double locus variant of ST180. Two additional fully susceptible clones, ST458 (11/77, 14%) and ST1116 (2/77, 3%), were found among the Israeli and Costa Rican strains, respectively. The same PFGE clusters identified among noninvasive infections were found among 50 isolates from carriers, with the same molecular characteristics. CONCLUSIONS: Serotype 3 accounts for a large proportion of mucosal disease in children, even before the introduction of PCV7. The data presented here describe for the first time the importance of a multidrug-resistant serotype 3 clone, ST505, in noninvasive infections.