New perspectives of immunomodulation and neuroprotection in glaucoma.

Glaucoma is the neurodegenerative disease of retinal ganglion cells. The main risk factor for glaucoma is increased intraocular pressure. The processes leading to cell death due to presence of the injury factor comprise multiple molecular mechanisms, as well as the immunological response. The knowledge of immunological mechanisms occurring in glaucomatous degeneration makes it possible to introduce glaucoma treatment modulating the cellular degradation. The glaucoma treatment of the future will make it possible not only to lower the intraocular pressure, but also to moderate the intracellular mechanisms in order to prevent retinal cell degeneration. Citicoline is a drug modulating glutamate excitotoxicity that is already in use. Rho kinase inhibitors were found to stimulate neurite growth and axon regeneration apart from lowering intraocular pressure. The complementary action of brimonidine is to increase neurotrophic factor (NTF) concentrations and inhibit glutamate toxicity. Immunomodulatory therapies with antibodies and gene therapies show promising effects in the current studies. The supplementation of NTFs prevents glaucomatous damage. Resveratrol and other antioxidants inhibit reactive oxygen species formation. Cell transplantation of stem cells, Schwann cells and nerve extracts was reported to be successful so far. Our review presents the most promising new strategies of neuroprotection and immunomodulation in glaucoma.

Immunological and molecular basics of the primary open angle glaucoma pathomechanism.

Glaucoma is a degenerative process of the optic nerve. Increased intraocular pressure is believed to be the main factor leading to the glaucomatous damage. The in vitro and in vivo animal glaucoma research models provide insight into the molecular changes in the retina in response to the injury factor. The damage is a complex process incorporating molecular and immunological changes. Such changes involve NF kB activity and complement activation. The processes affect the human antigen, JNK, MAPK, p53, MT2 and DBA/2J molecular pathways, activate the autophagy processes and compromise neuroprotective mechanisms. Activation and inhibition of immunological responses contribute to cell injury. The immunological mechanisms of glaucomatous degeneration include glial response, the complement, tumor necrosis factor α (TNF-α) pathways and toll-like receptors athways. Oxidative stress and excitotoxicity are factors contributing to cell death in glaucoma. The authors present an up-to-date review of the mechanisms involved and update on research focusing on a possible innovative glaucoma treatment.

Evaluation of the quality of postharvest rapeseed by means of an electronic nose.

BACKGROUND: Rapeseed is a valuable source of edible oil. The presence of even a small amount of mouldy or burnt rapeseed in a particular production batch deteriorates the quality of the edible oil obtained from it. Since the traditional method of using a panel of experts is time-consuming, there is a need for fast and easy methods for rapeseed quality evaluation by intelligent devices to replace human labour. RESULTS: For rapeseed quality evaluation, an electronic nose equipped with an array of eight quartz microbalance sensors and four metal oxide semiconductor sensors was used. Signals generated by the sensors were analysed by principal component analysis and discriminant function analysis. Identification of samples that contained small proportions of mouldy or burnt rapeseed was possible despite the differences between the particular varieties studied. CONCLUSION: Electronic nose technology has shown the possibility of detecting samples of faulty rapeseed at very low contamination levels and distinguishing them with high probability from sound rapeseed.

High incidence of large bore temporary hemodialysis catheter malfunction in patients with COVID-19 related kidney injury.

PURPOSE: To evaluate the incidence of large bore hemodialysis catheter malfunction in the setting of COVID-19. MATERIALS AND METHODS: A retrospective review was performed of all patients who underwent placement of a temporary hemodialysis catheter after developing kidney injury after COVID-19 infection at our institution. Data collected included demographic information, procedure related information, and incidence of replacement due to lumen thrombosis. Groups were compared using students t-test for continuous variables and Fisher's exact test for nominal variables. RESULTS: Sixty-four patients (43M, mean age 63.2 ± 13.3) underwent placement of temporary hemodialysis catheter placement for kidney injury related to COVID 19 infection. Thirty-one (48.4%) of catheters were placed via an internal jugular vein (IJV) access and 33 (52.6%) of catheters were placed via a common femoral vein (CFV) access. Overall, 15 (23.4%) catheters required replacement due to catheter dysfunction. There were no differences in demographics in patients who required replacement to those who did not (p > 0.05). Of the replacements, 5/31 (16%) were placed via an IJV access and 10/33 (30.3%) were placed via a CFV access (p = 0.18). The average time to malfunction/replacement was 7.8 ± 4.8 days for catheters placed via an IJ access versus 3.4 ± 3.3 days for catheters placed via a CFV access (p = 0.055). CONCLUSION: A high incidence of temporary dialysis catheter lumen dysfunction was present in patients with COVID-19 infection. Catheters placed via a femoral vein access had more frequent dysfunction with shorter indwelling time.

Pott's Puffy Tumor: Intracranial Extension Not Requiring Neurosurgical Intervention.

Pott's puffy tumor, typified by a subperiosteal abscess underlying the frontal bone, is an uncommonly encountered clinical entity that can occur in the setting of local trauma or secondary to frontal sinusitis. Diagnosis can be challenging, as cultures may be sterile, and the condition must be differentiated from neoplasm and superficial and soft tissue infection. Although more common in the pediatric population, Pott's puffy tumor must remain on the differential with a high index of suspicion in adult patients who fit the clinical picture. Early diagnosis with CT or MRI and therapeutic medical and surgical intervention are crucial as intracranial complications, such as abscess and empyema can occur and may be fatal. We present an adult patient with a history of inhaled drug abuse who presented with Pott's puffy tumor with meningitis and bifrontal epidural abscesses at presentation. There is evidence in the literature that management of sinus-related intracranial epidural abscess with antibiotic therapy and adequate surgical or endoscopic surgical drainage may bypass the need for neurosurgical intervention, as was the case here.