Comparison of first, second, and third versus the average of six probe-corneal touches for intraocular measurement of two rebound tonometers in healthy horses.

The aim of this study was to evaluate the intraocular pressure (IOP) measurements obtained from first, second, and third probe-cornea touch (PCT) and compare them with the average of six PCTs using two rebound tonometers in horses. This study enrolled a total of thirty-eight stallions, comprising of 24 Arabian horses and 14 cross-breeds (with an average age of 8 ± 3 years). The IOP measurements of first, second, and third, as well as the average of six PCTs were obtained using either Tonovet (TV) or Tonovet Plus (TV+) rebound tonometers. The mean differences (95% limits of agreement) between the average of six PCTs and the first, second, and third PCTs were 0.1 (-4.8 to 5), 0.2 (-4.8 to 4.5), and 0.2 (-3.6 to 4.0) mmHg with TV, respectively. With TV+, the differences were 0.3 (-6.6 to 7.2), 1.1 (-8.6 to 10.8), and -0.2 (-3.6 to 4.0) mmHg, respectively. Compared to the average of six PCTs, only 89.5%, 92.1%, and 97.4% of IOP measurements obtained from TV and 78.9%, 73.3%, and 65.8% of IOP measurements obtained from TV+ were within 4 mmHg of the average of six PCTs for first, second, and third PCTs, respectively. In conclusion, the measurement of IOP in the first PCT achieved best agreement with the IOP measurement of six average PCTs. Therefore, the first PCT could be considered as an alternative option for measuring IOP in horses when obtaining an average of six PCTs is not feasible.

Comparison of intraocular pressure in New Zealand White rabbits measured using rebound and applanation tonometers and four different methods of physical restraint.

AIMS: To compare intraocular pressure (IOP) measurements obtained in rabbits using rebound (TV) and applanation (TPV) tonometers with four different methods of physical restraint. METHODS: A total of 20 New Zealand White rabbits (40 eyes) were included in this study. IOP readings were obtained from both eyes using the two different tonometers. The rabbits were placed on a table and restrained by wrapping in a cloth (Method I), by scruffing with rear support (Method II), by wrapping in a cloth and cupped in the hands (Method III), or by a box restrainer (Method IV). RESULTS: The mean IOP measurement obtained by TPV was higher than that obtained with the TV for all handling methods. Mean differences (TV-TPV, in mmHg) in IOP were -5.3 (95% Cl = -6.5 to -4.1) for Method 1, -4.7 (95% Cl = -6.2 to -3.29) for Method II, -4.9 (95% Cl = -6.2 to -3.7) for Method III and -7.6 (95% Cl = -9.2 to -5.9) for Method IV. Using the TV tonometer, mean IOP for Method IV was higher than for Method I (mean difference 2.1 (95% Cl = 1.1-3.1)), whereas using the TPV tonometer, mean IOP for Method IV was significantly higher than Method I, II, and III (mean differences: 4.4 (95% Cl = 2.6-5.9), 3.7 (95% Cl = 2-5.3) and 3.8 (95% Cl = 2-5.4), respectively). According to Bland-Altman plots, IOP readings for TPV tended to be higher than those for TV with all handling methods, but with a lack of agreement. The mean difference and 95% limits of agreement for the differences between TV and TPV were -5.4 mmHg (-12.5-1.9 mmHg), -4.7 mmHg (-12.9-3.5 mmHg), -4.9 mmHg (-12-2.2 mmHg), and -7.5 mmHg (-17.4-2.3 mmHg), with Methods I, II, III, and IV, respectively. Comparing TV and TPV, only 7.5%, 12.5%, 27.5%, and 15% of IOP measurements from 20 rabbits were within the range considered clinically acceptable for IOP (± 2 mmHg) for Method I, II, III, and IV, respectively. CONCLUSION AND CLINICAL RELEVANCE: In conclusion, the physical restraint method should be recorded when IOP is measured in rabbits, and TV and TPV tonometers cannot be used interchangeably (high bias and low proportion of measurements within ± 2 mmHg).

Falls in elderly hemodialysis patients.

The elderly, (age ≥ 65 years) hemodialysis (HD) patient population is growing rapidly across the world. The risk of accidental falls is very high in this patient population due to multiple factors which include aging, underlying renal disease and adverse events associated with HD treatments. Falls, the most common cause of fatal injury among elderly, not only increase morbidity and mortality, but also increase costs to the health system. Prediction of falls and interventions to prevent or minimize fall risk and associated complications will be a major step in helping these patients as well as decreasing financial and social burdens. Thus, it is vital to learn how to approach this important problem. In this review, we will summarize the epidemiology, risk factors, pathophysiology and complications of falls in elderly HD patients. We will also focus on available methods to assess and predict the patients at higher risk of falling and will provide recommendations for interventions to reduce the occurrence of falls in this population.

In utero MR imaging and management of foetal hydrocephalus and NTDs in the third trimester.

Although ultrasound (US) remains the gold standard in foetal imaging, in utero magnetic resonance (MR) imaging of the foetal nervous system may be useful in the late stages of pregnancy. The authors performed MR scanning in pregnant women in whose foetuses US examination had shown hydrocephalus and neural tube defects (NTDs). These cases are definitely diagnosed as hopeless at such a late stage. In this report, three pregnant patients are presented to illustrate the morphological imaging features, and their outcome is discussed. This report is an example of how radiological investigations can be most valuable, when US and MR imaging are used as complementary in imaging of the foetuses.

The management of carpal tunnel syndrome in pregnancy.

OBJECTIVES: To determine the prevalence of carpal tunnel syndrome (CTS) after delivery and its relationship to individual factors. STUDY DESIGN: A cohort of 46 pregnant women, aged 15-48 years, who had suffered from CTS during pregnancy and who had delivered at Aydin Maternity Hospital, Turkey was selected. They had been followed up through pregnancy and 12 months postpartum and filled out a questionnaire. The data were analysed statistically. RESULTS: Follow up showed that CTS at 6 and 12 months post partum was reported by 10.9% and 4.3% of the women, respectively. The difference in prevalence of CTS between young women and older women was statistically significant (P= 0.005). The history of diabetes mellitus and infant birth weight were similar in the two groups. However, patient weight gain during pregnancy increased the risk of CTS (P= 0.000). On the other hand, there was no difference in the number of previous pregnancies between women with CTS and without CTS during pregnancy (P= 0.210). Furthermore, affected and unaffected groups required Caesarean section in nine and 248 patients during pregnancy, respectively. CONCLUSION: These results indicate that, in most pregnant patients with CTS, the symptoms are present in both hands and are first noted during the third trimester. The majority of patients with CTS obtain spontaneous relief in the immediate postpartum period.

Extremely rare type of conjoined twins: cephalothoracopagus deradelphus.

Occurrence of conjoined twins (CT) with a chromosomal abnormality is a very rare event. The case presented is that of a cephalothoracopagus Deradelphus twin with one cerebrum and two brain stems joined at the cranial end of the midbrain. This rare condition and its diagnosis and management are discussed with regard to counselling and obstetrical care.

A prospective study of persistent back pain after pregnancy.

OBJECTIVES: To determine the prevalence of back pain after delivery and its relationship to individual factors. STUDY DESIGN: A cohort of 88 pregnant women, aged 14-46 years, who had suffered from back pain during pregnancy, and delivered at Aydin Maternity Hospital was selected. They had been followed up through pregnancy, and 6 months post partum filled out a questionnaire. The data were analyzed statistically. RESULTS: Follow-up showed that back pain at the time of delivery and 6 months post partum was reported by 59.1% and 43.2% of the women, respectively. The difference in prevalence of back pain between young women and older ones was statistically significant (P=0.000). The number of previous pregnancies increased the risk of back pain (P=0.000), but there was no difference in prevalence of back pain between women with heavy work and without heavy work before pregnancy (P=0.310). Furthermore, women with a history of back pain before pregnancy were found to experience more intense pain at 6 months post partum compared to those without a history of back pain before pregnancy (2.1+/-1.0 and 0.4+/-0.4. respectively. P=0.000). CONCLUSION: These results indicate that pregnant women with a previous history of back pain had a higher prevalence of back pain, especially in young multigravid patients.

Lumbosacral plexus compression by fetus: an unusual cause of radiculopathy during teenage pregnancy.

A case is reported of a lumbosacral plexus compression by the fetus in a young 34-weeks pregnant woman, who had low-back pain and progressive muscular weakness of the leg. Neurological examination showed a grade IV motor weakness of the iliopsoas, quadriceps femoris and biceps femoris muscles. Mechanical stretch manoeuvers were negative. Electromyography revealed denervation activity in L4 and L5 muscles. Lumbosacral plexus radiculopathy was diagnosed. Although fetal compression appears to be an uncommon cause of lumbosacral radiculopathy during teenage pregnancy, both neurosurgeons and obstetricians should be aware of the possibility.

Granular cell myoblastoma of the cervix in a 14 year old girl.

Granular cell tumor (GCT) is a relatively uncommon, nearly always benign neoplasm that has been described in many sites and organs. We present a case of granular cell myoblastoma of the cervix in a 14 year old girl. Clinical presentation of the patient, treatment approach and histopathological features of the lesion are discussed.