Topographic typology in a consecutive series of refractive surgery candidates.

PURPOSE: The term 'keratoconus (KC) suspect' is used as a blanket term to refer to any deviation of virgin cornea shape toward KC features. We intend to subclassify such topographies in meaningful and informative designations. METHODS: Pentacam corneal topographies of 199 consecutive refractive surgery candidates (398 eyes) are examined. Features of steepness, inferior-superior asymmetry, focal steepening, thinning, and bounded anterior or posterior elevations are observed in the quad map. Scissoring on retinoscopy, loss of best spectacle-corrected visual acuity, and iron ring deposition were looked for. Through iterative observation and refinement of classification criteria-partly taken from the literature-all eyes were designated a specific topographic diagnosis, i.e., circumventing the usage of the expression KC 'suspect'. RESULTS: Topographies of 308, 48, 21, 13, 6, 1, and 1 (collectively 398 eyes) were designated: normal, 'atypical normal,' forme fruste KC, posterior KC, subclinical/mild KC, superior KC, and pseudo-KC, respectively. CONCLUSION: Current imaging modalities of the cornea and our accumulated experience in refractive science allow assignment of distinctive designations for abnormal corneal shapes along the topography spectrum. We devised and used the expressions: normal, atypical normal, forme fruste (arrested-incomplete) KC, posterior KC, subclinical (active latent) KC, superior KC, and pseudo-keratoconus. Identification of 1.5% (mild) KC highlights the importance of screening for ultraviolet cross-linkage candidacy in refractive surgery referrals.

The influence of maternal ketonuria on fetal well-being tests in postterm pregnancy.

BACKGROUND: Although it is well-known that postterm pregnancies are associated with the risk of perinatal morbidity and mortality, a comprehensive study on its management is lacking. The aim of present study was to determine whether ketonuria is associated with abnormal fetal test results in pregnancies >40 weeks of gestation. METHODS: In this analytical cross sectional study, a total of 360 pregnant women with gestational age of >40 weeks were evaluated in two hospitals during 2003 - 2004. For each woman, urinary ketones, glucose, pH, proteins, and specific gravity were measured by total screen LSG tapes (Rapignost); in addition, biophysical profile test was recorded and the amniotic fluid index was assessed by ultrasonography. RESULTS: Ketonuria was found in 34 women (9.44%). Statistical analyses showed that maternal ketonuria was associated with oligohydramnios, abnormal fetal tests, and a significant increase in fetal heart rate decelerations. CONCLUSION: Patients with clinically-detectable ketonuria have higher risk for abnormal fetal tests in comparison with those without the disease.

Potential human health risk assessment of trace metals via the consumption of marine fish in Persian Gulf.

This study was carried out to evaluate the concentration of trace metals (Cd, Cu, Ni, Pb and Zn) in the muscle of four fish species from the Persian Gulf. Trace metals were analyzed using atomic absorption spectroscopy and consumption rates advisory for minimizing chronic systemic effects in children and adults were estimated. The metals concentrations in analyzed fish samples were lower than legal limits. Cadmium target hazard quotient values suggested that the threshold to avoid the potential risk for children health is an exposure level lower than 3 meals per week. Hazard index values based on four metals (not including Pb) for the child age class were higher than those of the adult age class, suggesting that children may suffer from a higher health risk. This study provides information about the consumption limits of certain metals, in particular Cd, necessary for minimizing potential health risks resulting from human consumption.