Effects of an antioxidant protective topical formulation on eye exposed to ultraviolet-irradiation: a study in rabbit animal model.

Ultraviolet-radiation exerts a well-known role in the development of various ocular diseases and may contribute to the progress of age-related macular degeneration. Therefore, the use of compounds able to protect the eyes from UV-induced cellular damage is challenging. The aim of this study has been to test the protective effects of an antioxidant topical formulation against UV-induced damage in rabbit eyes. Twelve male rabbits were used. Animals were divided into 4 groups of 3 animals each. Control group (CG) did not receive any irradiation and/or eye drop. The other three experimental groups were treated as follows: the first group received only UVR irradiation for 30 min, without eye drop supplementation (Irradiation group, IG), the second (G30) and the third (G60) groups received UV irradiation for 30' and 60', respectively, and eye drop supplementation (riboflavin, d-alpha-tocopheryl polyethylene glycol, proline, glycine, lysine and leucine solution) every 15 min for three hours. In the IG group a significant increase of oxidized glutathione (GSSG) and hydrogen peroxide (H(2)O(2)) was recorded in the aqueous humor, whereas ascorbic acid levels were significantly lower when compared to control eyes. In the groups exposed to UVR rays for 30 min, and treated with the topical antioxidant formulation, the GSSG, H(2)O(2) and ascorbic acid levels were similar to those recorded in controls, whereas in the G60 group the three markers significantly differ from control group. In the lens, a significant decrease of alpha tocopherol and total antioxidant capacity (TAC) was recorded in IG-animals as compared to control group, whereas malondialdehyde (MDA) levels were significantly higher in UV-induced eye than in control eyes. In the G30 groups the alpha tocopherol, MDA and TAC levels do not significantly differ from those recorded in controls, whereas in the G60 group these three markers significantly differ from control group. Present findings demonstrate that topical treatment with the antioxidant formulation used herein protects ocular structures from oxidative stress induced by UV exposure in in vivo animal model.

The effect of Laurus nobilis on the blood and lenses antioxidant activity in rabbit under fat-enriched diet.

Fat-enriched diet is strongly associated with cataract development. Laurus nobilis shows antioxidant activity. Herein we evaluated the effect of Laurus nobilis oral administration on the blood and lenses antioxidant activity in rabbits under fat-enriched diet. Sixty rabbits divided into 4 groups were used. One group represented the control (N-CTR). The second group (P-CTR) fed a diet supplemented with 2.5 % of pig fat; the third group (EXP1) received a diet supplemented with 2.5 % of pig fat and 1 g/kg of dried-bay leaves; the fourth group (EXP2) was treated with dried-bay leaves at the rate of 1 g/kg of feed. At baseline and at the end of the study (56 days) the following blood parameters were determined: thiobarbituric acid reactive substances (TBARS), reactive oxygen metabolites (ROMs), total phenols, superoxide dismutase (SOD), oxygen radical absorbance capacity (ORAC(pca)), ferric ion reducing antioxidant power (FRAP), retinol and alfa-tocopherol. At the end of the follow-up, the eyes were enucleated and the antioxidant profile, such as total antioxidant activity (TAC), TBARS, retinol and alfa-tocopherol of lenses was evaluated. Plasma ROMs and TBARS levels were statistically lower in the groups receiving bay leaves integration. A significant increase of plasma retinol, FRAP and ORAC(pca) levels was found in EXP1 and EXP2 groups, whereas plasma alfa-tocopherol resulted statistically higher only in EXP2 group. Bay leaves supplementation enhanced TAC, retinol and alfa-tocopherol in rabbit lens, particularly in EXP2 group; whereas lenses TBARS levels significantly decreased in both treated groups. These findings demonstrate that Laurus nobilis oral administration exerts a protective effect on the risk of cataract development in rabbits under fat-enriched diet.

Cigarette smoking in patients with obsessive compulsive disorder: a report from the International College of Obsessive Compulsive Spectrum Disorders (ICOCS).

Obsessive compulsive disorder (OCD) showed a lower prevalence of cigarette smoking compared to other psychiatric disorders in previous and recent reports. We assessed the prevalence and clinical correlates of the phenomenon in an international sample of 504 OCD patients recruited through the International College of Obsessive Compulsive Spectrum Disorders (ICOCS) network. Cigarette smoking showed a cross-sectional prevalence of 24.4% in the sample, with significant differences across countries. Females were more represented among smoking patients (16% vs 7%; p<.001). Patients with comorbid Tourette's syndrome (p<.05) and tic disorder (p<.05) were also more represented among smoking subjects. Former smokers reported a higher number of suicide attempts (p<.05). We found a lower cross-sectional prevalence of smoking among OCD patients compared to findings from previous studies in patients with other psychiatric disorders but higher compared to previous and more recent OCD studies. Geographic differences were found and smoking was more common in females and comorbid Tourette's syndrome/tic disorder.

FOLFIRI regimen: an effective second-line chemotherapy after failure of etoposide-platinum combination in patients with neuroendocrine carcinomas grade 3.

Patients with neuroendocrine carcinomas (NECs) grade 3 have a poor prognosis. Etoposide-platinum combination is the standard chemotherapy but the role of a second-line therapy remains unknown. Irinotecan alone or in combination has shown some efficacy in patients treated for small cell lung cancer which had pathological similarities with neuroendocine tumors. The aim of this study is to determine safety and efficacy of the FOLFIRI regimen in patients with NECs grade 3 after failure of etoposide-platinum combination. This study was retrospective, including patients with NECs grade 3 and treated with the FOLFIRI regimen after progression or toxicity of etoposide-platinum combination in first-line. Patients with Eastern Cooperative Oncology Group (ECOG) performance status ≥3 and/or serum alkaline phosphatase ≥5×upper limit of normal value (ULN) and/or bilirubin ≥1.5×ULN were excluded. Among 39 patients who failed etoposide-platinum combination, 19 (49%; 12 women, median age 53 (29-78) years) received the FOLFIRI regimen with a median number of 6 (1-16) courses. Six patients (31%) had at least one episode of grades 3-4 toxicity (neutropenia, n=3; diarrhea, n=3) without toxic death. Six patients (31%) had objective response, 6 (31%) stable disease, and 7 (38%) tumor progression. Median progression-free survival under FOLFIRI was 4 months. Overall survival was 18 vs 6.8 months in noneligible patients. FOLFIRI regimen is a safe and potentially efficient chemotherapy given as second-line in patients with NECs grade 3 who remain in good condition and with correct liver tests after failure of etoposide-platinum combination. These results should be confirmed in a future prospective study.

Caveolin-1 is expressed on multipotent cells of hair follicles and might be involved in their resistance to chemotherapy.

BACKGROUND: Caveolin-1 is the principal protein that composes caveolae, which are vesicular invaginations present on the plasma membrane of different cell types. Caveolae are involved in a variety of cellular functions including regulation of proliferation rate and resistance to chemotherapeutic drugs. Chemotherapy frequently induces alopecia which is reversible most probably due to the low proliferative rate of hair follicle stem cells and due to the expression of proteins which confer resistance. OBJECTIVES: Using a specific animal model and immunohistochemistry, we analysed the expression of both caveolin-1 and the cell proliferation marker beta-catenin, at different stages of the hair follicle cycle, both before and after doxorubicin (DXR) -induced alopecia. METHODS: Seven-week-old C57BL/6 mice were depilated in order to synchronize hair follicle cycle in the anagen phase. Chemotherapy with DXR 15 mg kg(-1) was used to induce alopecia. Control and treated mice were then sacrificed at precise time points and caveolin-1 expression in hairs at different stages of the cycle were analysed by immunohistochemistry. By double immunofluorescence, colocalization of caveolin-1 and cytokeratin-15 was confirmed in the bulge region. The state of proliferation of cells composing hair follicle was assessed by beta-catenin immunohistochemistry. RESULTS: Caveolin-1 was expressed by the cells of the bulge area, the multipotent compartment of the hair follicle, during all phases of growth (anagen), regression (catagen) and resting (telogen). During the anagen phases, nuclear beta-catenin labelling was not observed in bulge cells, but rather in the deeper portion of the follicle. Damaged hair follicles from DXR-treated mice presented bulge cells which still expressed caveolin-1, suggesting that this protein might play a role in their drug resistance. As expected, no beta-catenin nuclear staining was detectable in DXR-treated hair follicles, indicating the complete lack of proliferative processes. The differential localization of caveolin-1 and beta-catenin suggests that the mutually exclusive expression of these proteins is useful for correct hair regrowth, whether during the physiological cycle or after chemotherapy-induced alopecia. CONCLUSIONS: Expression of caveolin-1 within the multipotent cell compartment of the hair follicle can explain the resistance of bulge cells to many chemotherapeutics, suggested by the reversibility of chemotherapy-induced alopecia.

An impaled neck. Management of difficult airway access.

We describe the management of a patient impaled through the lower submandibular area by the top spike of some iron railings which immobilised his jaw and blocked access to the trachea. The Fire Brigade used specialised equipment to cut out a section of the railings so that the patient could be transported to hospital. Awake fibreoptic intubation was used to gain access to the patient's airway before induction of anaesthesia.

Logistic regression analysis of fixed patient factors for postoperative sickness: a model for risk assessment.

One hundred and forty-seven patients undergoing minor orthopaedic surgery were studied prospectively by logistic regression analysis to determine the association of independent fixed patient factors with the incidence of postoperative sickness (nausea, retching or vomiting). Gender, history of previous postoperative sickness, postoperative opioids and interaction between gender and previous history of sickness were significant independent factors for postoperative sickness; history of motion sickness was weakly associated. The probability of postoperative sickness in the first 24 h after surgery may be estimated from the equation: logit postoperative sickness = -5.03+2.24(postoperative opioids) +3.97 (previous sickness history) +2.4 (gender) +0.78 (motion sickness) -3.2 (gender x previous sickness history). (Log likelihood ratio test for 5 degrees of freedom for the coefficients, chi-square = 53.5 (P < 0.001).) It is suggested that the calculated probability for sickness may be a useful addition for balancing patient treatment groups and allowing between-study comparisons.

Air embolism during total hip replacement: comparison of two surgical techniques.

The frequency of air embolism was studied in 21 patients during total hip replacement. Two groups were examined, one having femoral shaft cement insertion by hand, the other by Exeter cement gun. Venous air embolism was common throughout the hip surgery, but was especially so during prosthesis positioning in the femoral shaft. There were fewer air emboli and cardiovascular sequelae detected in the gun-inserted cement group, and the only patients to show clinically significant cardiovascular abnormalities during insertion of cement and prosthesis were those having cement insertion by hand. We conclude that the incidence of air embolism and associated cardiovascular changes during total hip replacement may be expected to be reduced in those patients in whom a cement gun is used to place the cement.

Clinical experience with alfentanil for induction of anaesthesia; a comparison with thiopentone.

Alfentanil, a new short-acting narcotic was clinically evaluated as an intravenous anaesthetic induction agent in 19 patients and compared to 20 patients receiving thiopentone. Alfentanil was superior to thiopentone in cardiovascular stability, both during induction of anaesthesia and tracheal intubation. However, alfentanil does not behave like a typical induction agent, time to unconsciousness is longer and more variable and is often accompanied by muscle rigidity. The results of this study suggest that alfentanil is more difficult to use as an induction agent than thiopentone, but alfentanil is recommended for short procedures when haemodynamic stability is important.