Surfactant administration methods for premature newborns: LISA vs. INSURE comparative analysis

INTRODUCTION

Respiratory Distress Syndrome (RDS) is the most common respiratory disorder among premature infants. The use of surfactant has significantly reduced respiratory complications and mortality. There are two conventional methods for administering surfactant: Intubate-Surfactant-Extubate (INSURE) and Less Invasive Surfactant Administration (LISA). This study aims to compare the effects of surfactant administration using these two methods on the treatment outcomes of premature newborns.

MATERIALS AND METHODS

In this retrospective cohort study, we included 100 premature newborns with RDS and spontaneous breathing who were admitted to the Neonatal Intensive Care Unit of Besat Hospital in Sanandaj city in 2021. Exclusion criteria comprised congenital anomalies and the needing for intubation for resuscitation at birth. The outcomes of epmericaly trated with two methods were compared: the LISA (50 neonates) and the INSURE (50 neonates). Our interesting outcomes were needing for mechanical ventilation, duration of ventilation, pneumothorax, pulmonary hemorrhage, severe retinopathy, CPAP duration, and bronchopulmonary dysplasia. Finally, we entered the data into STATA-14 statistical software and analyzed it using chi-square and t-tests.

RESULTS

In this study, 69% of the neonates were boys. The LISA group exhibited significantly lower rates of need for mechanical ventilation (P = 0.003) and ventilation duration (P < 0.001) compared to the INSURE group. Conversely, there were no significant differences between the two groups (P > 0.05) in terms of pneumothorax, pulmonary hemorrhage, severe retinopathy, CPAP duration, and bronchopulmonary dysplasia rates.

CONCLUSION

The results of this study suggest that the LISA method is a safe and non-invasive approach for surfactant administration. Notably, it resulted in a reduced need for mechanical ventilation and decreased ventilation duration compared to the INSURE method.

Heterotopic gastrointestinal cyst within the submandibular space in an adult: A case report and review of the literature

Heterotopic gastrointestinal cysts (HGIC) are rare congenital cysts that arise anywhere along the gastrointestinal tract. HGICs are infrequently reported in the oral cavity; 0.3% of HGICs are reported in the tongue and even more rarely in the submandibular space. Oral HCIGs are more common in children with only 13 reported cases in adults. In the present report, we discuss the differential diagnoses of the submandibular space lesions and describe a rare case of a very large submandibular space HGIC in an adult patient.

Study of the structural, electronic, magnetic and magnetocaloric properties of La0.5Ca0.5Mn0.9V0.1O3 sample: first-principles calculation (DFT-MFT)

This paper presents a correlation between experimental and theoretical approaches to study the structural, electronic, magnetic, and magnetocaloric properties of La_0.5Ca_0.5Mn_0.9V_0.1O₃. The studied compound crystallizes in the Pbnm orthorhombic space group. The calculated DOS using the DFT + U method proves that La_0.5Ca_0.5Mn_0.9V_0.1O₃ sample exhibits semi-metallic behavior, which is preferred in spintronic applications. The calculated PDOS proves that the high hydration among Mn 3d, V 3d and O 2p at the Fermi energy level is responsible for the FM behavior of La_0.5Ca_0.5Mn_0.9V_0.1O₃. The magnetic moment has been calculated using DFT results by estimating the valence electron population. The optical properties show high light absorption in the UV region. By using the Bean-Rodbell method, the magnetic phase shows a second-order transition where η = 0.85, and the exchange parameter λ is found to be 1.19 T g^-1 emu^-1. Based on the mean-field theory, the saturation magnetization (M ₀), the Landé factor (g), and the total angular momentum (J) were determined. These parameters were used to simulate magnetization as a function of the magnetic field at different temperatures as well as the variation of the magnetic entropy change ΔS _M (T).

Evolving global and national criteria for identifying a suspected case of COVID-19

Background

The outbreak of coronavirus disease 2019 (COVID-19) began in December 2019 and continues to spread worldwide. Rapid and accurate identification of suspected cases is critical in slowing spread of the virus that causes the disease. We aimed to highlight discrepancies in the various criteria used by international agencies and highly impacted individual countries around the world.

Methods

We reviewed the criteria for identifying a suspected case of COVID-19 used by two international public health agencies and 10 countries across Asia, Europe, and North America. The criteria included information on the clinical causes of illness and epidemiological risk factors. Non-English language guidelines were translated into English by a co-author who is fluent in that particular language.

Results

Although most criteria are modifications of World Health Organization recommendations, the specific clinical features and epidemiological risks for triggering evaluation of patients with suspected COVID-19 differed widely among countries. The rationale for these differences may be related to each country’s resources, politics, experience with previous outbreaks or pandemics, health insurance system, COVID-19 outbreak severity, and other undetermined factors.

Conclusion

We found no consensus regarding the best diagnostic criteria for identifying a suspected case of COVID-19.

Synthesis and Characterization of N- Doped ZnO-γAl2O3 Nanoparticles for Photo-catalytic Application

In this study, photo-catalytic degradation of methyl orange (MO) azo dye was examined by undoped and Ce2O3/ CuO/ N doped ZnO nanoparticles stabilized on γAl2O3. Highest photo-catalytic activity was observed for the N-doped 10 wt. % ZnO-γAl2O3 sample. One of the optimal points with the complete MO decomposition was determined at an initial concentration of 8.25 ppm, pH 3.25, catalyst loading of 0.36 g/L and 12.56 W UV-light irradiation after 120 min. Physical and chemical properties of materials were investigated by X-ray diffraction analysis (XRD), Fourier-transform infrared (FTIR) spectroscopy, scanning electron microscopy (SEM), Brunauer–Emmett–Teller (BET) and UV–visible diffuse reflectance spectroscopy (DRS) method. The experimental data were best fitted by a Langmuir-Hinshelwood approach photo-catalysis developed kinetic reaction rate in the form of $- r = 0.2797\, {I^{0.5}}\, {[Cat.]^{0.5}}\, \, [Dye]{\text{ }}/\, \, \, 1 + 0.1079\, {[Dye]_0}\, + \, 0.4086\, {I^{0.5}}\, {[Cat.]^{0.5}}$.

Increased number of regulatory T cells in esophageal tissue of patients with eosinophilic esophagitis in comparison to gastro esophageal reflux disease and control groups

BACKGROUND

Eosinophilic esophagitis (EoE) is a primarily polygenic allergic disorder. Although most patients have IgE sensitization, it seems that non-IgE mediated responses mainly contribute to the pathogenesis of EoE. Regulatory T cells (Tregs) may have an important role in allergies. There are limited data on the association of Tregs and EoE. In this study, we enumerated and compared T lymphocytes and Tregs in esophageal tissue of patients with EoE, gastroesophageal reflux disease (GERD) and normal controls.

METHODS

Ten patients with EoE, ten patients with GERD and eight normal controls were included. Immunohistochemistry staining was used to enumerate T lymphocytes and Tregs. CD3+ cells were considered as T cells and FOXP3+, CD3+ cells were considered as Tregs. T cells and Tregs were counted in 10 high power fields (HPF) (×400) for each patient and the average of 10 HPFs was recorded.

RESULTS

The mean±SEM of Tregs in esophageal tissue of patients with EoE (10.90±2.14cells/HPF) was significantly higher than the GERD (2.77±0.66cells/HPF) and control groups (0.37±0.08cells/HPF) (P<0.001). Additionally, the mean±SEM of T lymphocytes in esophageal tissue of patients with EoE (24.39±3.86cells/HPF) were increased in comparison to the GERD (10.07±2.65cells/HPF) and control groups (3.17±0.93cells/HPF) (P<0.001).

CONCLUSION

There is an increase in the number of esophageal T lymphocytes and regulatory T cells in patients with EoE compared to the GERD and control groups.

Combined Evaluation of Noncontrast CT ASPECTS and CT Angiography Collaterals Improves Detection of Large Infarcts in Proximal Artery Occlusive Stroke

BACKGROUND AND PURPOSE

Imaging may identify patients with very large infarcts who are unlikely to benefit from intra-arterial therapy. Although computed tomography (CT) is widely used, it suffers from poor sensitivity. We sought to evaluate whether combined evaluation of noncontrast CT (NCCT) and CT angiography (CTA) collaterals would improve the detection of large infarcts.

METHODS

All patients with anterior circulation proximal artery occlusion and baseline CT, CTA, and magnetic resonance imaging (MRI) performed were identified. NCCT ASPECTS, CTA collateral score (CS), and diffusion-weighted imaging (DWI) lesion volume were determined. Receiver-operating characteristic analyses were performed to test the discrimination of NCCT ASPECTS 0-4, CTA malignant collaterals (CS = 0: absent collaterals in >50% of M2 territory), and the combination for DWI volume > 100 mL.

RESULTS

Among 54 patients, mean age was 67 years; median NIHSS was 14. Occlusion locations were ICA terminus (18 [33%]), MCA M1 (20 [37%]), and M2 (16 [30%]). Median NCCT ASPECTS was 8; 8 (15%) had ASPECTS 0-4. Median CTA CS was 2; 9 (17%) were categorized as malignant. Median DWI lesion volume was 25 mL; 12 (22%) had lesions >100 mL. Individually, the CTA malignant collateral profile (98%) and NCCT ASPECTS 0-4 (100%) demonstrated high specificity for DWI lesion volume >100 mL, but had suboptimal sensitivity (both 67%). In the combined approach (CTA CS = 0 and/or NCCT ASPECTS ≤4), the sensitivity improved significantly to 92%, while maintaining high specificity (98%).

CONCLUSIONS

Combined evaluation of NCCT ASPECTS and CTA collaterals identifies patients with infarcts >100 mL with high accuracy, and can improve patient selection using current CT techniques.

A Deep-Learning System for Fully-Automated Peripherally Inserted Central Catheter (PICC) Tip Detection

A peripherally inserted central catheter (PICC) is a thin catheter that is inserted via arm veins and threaded near the heart, providing intravenous access. The final catheter tip position is always confirmed on a chest radiograph (CXR) immediately after insertion since malpositioned PICCs can cause potentially life-threatening complications. Although radiologists interpret PICC tip location with high accuracy, delays in interpretation can be significant. In this study, we proposed a fully-automated, deep-learning system with a cascading segmentation AI system containing two fully convolutional neural networks for detecting a PICC line and its tip location. A preprocessing module performed image quality and dimension normalization, and a post-processing module found the PICC tip accurately by pruning false positives. Our best model, trained on 400 training cases and selectively tuned on 50 validation cases, obtained absolute distances from ground truth with a mean of 3.10 mm, a standard deviation of 2.03 mm, and a root mean squares error (RMSE) of 3.71 mm on 150 held-out test cases. This system could help speed confirmation of PICC position and further be generalized to include other types of vascular access and therapeutic support devices.

The added value of cross-sectional imaging in the detection of additional radiographically occult fractures in the setting of a Chopart fracture

PURPOSE

Radiography has a low sensitivity for the detection of fractures related to the talonavicular and calcaneocuboid articulations, also known as Chopart fractures. The purpose of this study is to determine the sensitivity of radiographs for detecting additional foot and ankle fractures related to Chopart fracture using CT or MRI as the reference standard.

METHOD

We performed an IRB-approved, retrospective review of radiology reports between 2010 and 2014. Inclusion criteria were (1) diagnosis of a Chopart fracture and (2) at least one radiograph and subsequent cross-sectional imaging (CT or MR). CT or MRI was considered the diagnostic reference standard. Results were stratified by the energy of trauma and by type of radiograph performed (weight-bearing (WB) versus non-WB).

RESULTS

One hundred eight patients met the inclusion criteria. The calcaneocuboid articulation was the most commonly involved type of Chopart fracture, seen in 75% of cases (81/108). Chopart fractures were detected on the initial radiographs in 67.6% of cases (73/108). Additional fractures of the ankle and midfoot were diagnosed in 34.2% of cases (37/108), with 56.7% (21/37) of these cases having at least one additional fracture seen on CT or MRI that was not seen on the initial radiographs, with fractures of the midfoot most often missed. In 56.7% (17/30) patients whose radiographs detected Chopart fractures, at least one additional fracture was missed; 30% of them demonstrated intra-articular extension and 56.7% were considered displaced. High-energy trauma was related to higher incidence of additional fractures. There was no significant difference in the sensitivity of radiographs to detect additional fractures between high versus low-energy trauma (p = 0.3) and WB versus non-WB radiographs (p = 0.5). Most patients were treated nonoperatively (56.5%, 61/108), with surgical intervention more frequent in patients with a high energy of trauma (51.7% versus 33.3%, p = 0.05).

CONCLUSION

In the setting of a Chopart fracture, CT or MRI can add significant value in the detection of additional ankle or midfoot fractures, irrespective of the energy of trauma. Since additional fractures can have important management implications, CT or MRI should be considered as part of the standard workup for all midfoot fractures.

Estimation of gait parameter using sonoelastography in children with cerebral palsy

We aimed to study the relationship between neuromuscular abnormalities associated with spasticity and gait impairments in spastic children with hemiplegia cerebral palsy (CP). Neuromuscular abnormalities of the tibialis anterior and medial gastrocnemius muscles of the spastic ankle were quantified using sonoelastography with two major features; i.e. entropy and histogram ratio of sonoelastography images. Gait impairments were evaluated in the gait laboratory using motion capture system, and the spatial and temporal features were extracted. The correlation analysis showed a significant relation between both the entropy and histogram ratio of sonoelastography images with walking speed and step time. The findings demonstrate that the neuromuscular abnormalities associated with spasticity may contribute to gait impairments in children with CP.

Induction of linalool as a pharmaceutical and medicinal metabolite via cell suspension culture of cumin (Cuminum cyminum L.)

Cumin is an important medicinal plant in Iran. Plant cell suspension culture is a method for the production of medicinal and secondary metabolites. The linalool is a plant secondary metabolite that has been recognized as a neuroprotective agent. The purpose of this study was to evaluate the effects of salicylic acid elicitor on induction of linalool in cell suspension culture of cumin. For this purpose, the cumin seeds were prepared, to obtain sterile seedling, were disinfected with sodium hypochlorite and alcohol, and were cultured on MS basal medium. This research was conducted in two separate experiments including callus induction and suspension cultures. Leaf explants were prepared from sterile seedlings and used to produce callus on MS medium supplemented with 1 mg/l NAA and 0.5 mg/l BAP. In order to establish suspension culture, the appropriate calli were transferred to liquid medium. Then cell cultures were treated with elicitors. The effects of elicitor on the production of linalool secondary metabolite and cell viability were assessed by GC-Mass and tetrazolium test respectively. For this purpose, the salicylic acid (at concentrations of 0, 1, 2, 4 and 8 mg/l) was used. The experimental design was a completely randomized design with five treatments and three replications. The results of cell culture and GC-Mass analysis showed that salicylic acid had significant effects on the linalool production (<0.01). At all concentrations of salicylic acid, viability of the cells in suspension culture experiments was lower than control. Increasing the elicitor concentrations lead to reduction in cell survival. In conclusion it is possible to produce linalool as a secondary metabolite and pharmaceutical agent in cell culture of cumin. It is necessary to determine the best combination of medium and elicitor.

In vitro induction of α-pinene, pulegone, menthol, menthone and limonene in cell suspension culture of pennyroyal (Mentha pulegium)

Medicinal plants are known as important sources of secondary metabolites. Because of the economic value of pennyroyal [Mentha pulegium L. (Lamiaceae)] in food industries, propagation of this valuable plant has special importance. Plant cell suspension culture can increase some produced components. The aim of this research was performing cell culture for induction of some secondary metabolites of M. pulegium and compares it with native one. The MS medium was used for suspension culture. To investigate quantitative materials, 4 levels of yeast extract elicitor (20, 40, 60 and 80 mg/L) and salicylic acid in 4 levels (2, 4, 6 and 8 mg/L) were used. Obtained extracts were analyzed by GC-MS. Statistical analysis showed that the amount of limonene, menthone, menthol and α-pinene were more than mentioned compounds in natural plant as control. The maximum amount of this metabolites were obtained as limonene (in 60 mg/l yeast extract), menthone (in 40 mg/l yeast extract and 2 mg/l salicylic acid), menthol (in 6 mg/l salicylic acid) and α-pinene (in 4 mg/l salicylic acid) in the M. pulegium cell culture. The Pulegone was fond more in natural plants than cell culture mass. The most important secondary metabolites were increased by cell culture containing of salicylic acid and yeast extract elicitors in M. pulegume.

Rating and Classification of Incident Reporting in Radiology in a Large Academic Medical Center

The purpose of this article is to provide a rate of safety incident report of adverse events in a large academic radiology department and to share the various types that may occur. This is a Health Insurance Portability and Accountability Act compliant, institutional review board-approved study. Consent requirement was waived. All incident reports from April 2006-September 2012 were retrieved. Events were further classified as follows: diagnostic test orders, identity document or documentation or consent, safety or security or conduct, service coordination, surgery or procedure, line or tube, fall, medication or intravenous safety, employee general incident, environment or equipment, adverse drug reaction (ADR), skin or tissue, and diagnosis or treatment. Overall rates and subclassification rates were calculated. There were 10,224 incident reports and 4,324,208 radiology examinations (rate = 0.23%). The highest rates of the incident reports were due to diagnostic test orders (34.3%; 3509/10,224), followed by service coordination (12.2%; 1248/10,224) and ADR (10.3%; 1052/4,324,208). The rate of incident reporting was highest in inpatient (0.30%; 2949/970,622), followed by emergency radiology (0.22%; 1500/672,958) and outpatient (0.18%; 4957/2,680,628). Approximately 48.5% (4947/10,202) of incidents had no patient harm and did not affect the patient, followed by no patient harm, but did affect the patient (35.2%, 3589/10,202), temporary or minor patient harm (15.5%, 1584/10,202), permanent or major patient harm (0.6%, 62/10,202), and patient death (0.2%, 20/10,202). Within an academic radiology department, the rate of incident reports was only 0.23%, usually did not harm the patient, and occurred at higher rates in inpatients. The most common incident type was in the category of diagnostic test orders, followed by service coordination, and ADRs.

Macracanthorhynchus hirudinaceus: the most common helminthic infection of wild boars in southwestern Iran

A pathological and epidemiological study on Macracanthorhynchus hirudinaceus infection on 25 wild boars Sus scrofa in southwestern Iran was done. Overall 24 helminthes (18 female and 6 male) were collected from the intestine of 13 infected wild boars. Thus, the prevalence of acanthocephalans among the 25 examined boars was 52 %. Pathological evaluation revealed damages caused by the acanthocephalans penetrated in the small intestine tissue. Helminthes caused severe necrosis with ulcer and inflammation in tunica sub mucosa layer. High prevalence of this helminthic infection may cause severe hazard for farmers, residents and also wild life animals.

Pre-placement psychological status and staff retention in a call centre

BACKGROUND

There is a general lack of studies on staff retention and mental health status at the beginning of or prior to employment in call centres.

AIMS

To evaluate the relationship between psychological status at the beginning of employment and staff retention after 6 months of employment.

METHODS

The psychological well-being of new starters was evaluated using a questionnaire and Beck Depression Inventory (BDI). Early leavers were identified through a second survey performed 6 months later.

RESULTS

Out of a cohort of 135 new starters, all of the 100 randomly selected employees returned their questionnaires. By the second round of the survey 6 months later, 30 employees had left. There was no significant difference between the BDI scores of leavers and those who remained in the company. Binary logistic regression showed no significant associations between leaving the company and gender, previous history of mental health diagnosis and history of mental health treatment. However, there was a significant association between age (25 or over) and leaving the company within the first 6 months of employment (odds ratio [OR] = 2.5; 95% confidence interval [CI] 1.04-6.01; P < 0.05).

CONCLUSIONS

Previous mental health conditions or psychological status at the beginning of employment did not appear to contribute significantly to call centre employees leaving within 6 months. Further similar studies in other occupational sectors are recommended.

Critical behavior study near the paramagnetic to ferromagnetic phase transition temperature in Pr0.6−xErxCa0.1Sr0.3MnO3 (x = 0, 0.02 and 0.06) manganites

The aim of the present work is to study the critical behavior of Pr_0.6−xEr_xCa_0.1Sr_0.3MnO₃ (x = 0, 0.02 and 0.06) manganites, synthetized by the conventional solid-state reaction method, around the paramagnetic (PM)–ferromagnetic (FM) phase transition.

Analysis of the small break loss of coolant accident in the VVER-1000/V446 reactor

In this paper, the analysis of a Small Break Loss of Coolant Accident (SBLOCA) in the VVER-1000/V446 nuclear power plant is presented. For a conservative analysis of the accident, the loss of power to the NPP and failure of one accumulator, and also of two emergency core cooling systems (ECCS) in loops 2 and 3 of the primary and secondary circuits are considered when SBLOCA has occurred. The RELAP5/MOD3.2 computer code has been used in performing the analyses. Two cases of accident scenarios as 25 mm and 100 mm breaks are analyzed. The results are in good agreement with those reported in the plant's FSAR. The results of liquid velocity show that in both cases, the flow of hot legs after the break is reversed, which provides the potential for reflux condensation phenomena. Furthermore, in the 25 mm break, the flow rate in the broken and intact side downcomer remains in the downward motion while in the 100 mm break, the broken and intact side flow rate changes to the reversed state alternatively.

How often are Patients Harmed When They Visit the Computed Tomography Suite? A Multi-year Experience, in Incident Reporting, in a Large Academic Medical Center

OBJECTIVES

Our goal is to present our multi-year experience in incident reporting in CT in a large medical centre.

METHODS

This is an IRB-approved, HIPAA-compliant study. Informed consent was waived for this study. The electronic safety incident reporting system of our hospital was searched for the variables from April 2006 to September 2012. Incident classifications were diagnostic test orders, ID/documentation, safety/security/conduct, service coordination, surgery/procedure, line/tube, fall, medication/IV safety, employee general incident, environment/equipment, adverse drug reaction, skin/tissue and diagnosis/treatment.

RESULTS

A total of 1918 incident reports occurred in the study period and 843,902 CT examinations were performed. The rate of safety incident was 0.22 % (1918/843,902). The highest incident rates were due to adverse drug reactions (652/843,902 = 0.077 %) followed by medication/IV safety (573/843,902 = 0.068 %) and diagnostic test orders (206/843,902 = 0.024 %). Overall 45 % of incidents (869/1918) caused no harm and did not affect the patient, 33 % (637/1918) caused no harm but affected the patient, 22 % (420/1918) caused temporary or minor harm/damage and less than 1 % (10/1918) caused permanent or major harm/damage or death.

CONCLUSION

Our study shows a total safety incident report rate of 0.22 % in CT. The most common incidents are adverse drug reaction, medication/IV safety and diagnostic test orders.

KEY POINTS

• Total safety incident report rate in CT is 0.22 %. • Adverse drug reaction is the most common safety incident in CT. • Medication/IV safety is the second most common safety incident in CT.

Adaptive variable structure hierarchical fuzzy control for a class of high-order nonlinear dynamic systems

In this paper, a novel adaptive hierarchical fuzzy control system based on the variable structure control is developed for a class of SISO canonical nonlinear systems in the presence of bounded disturbances. It is assumed that nonlinear functions of the systems be completely unknown. Switching surfaces are incorporated into the hierarchical fuzzy control scheme to ensure the system stability. A fuzzy soft switching system decides the operation area of the hierarchical fuzzy control and variable structure control systems. All the nonlinearly appeared parameters of conclusion parts of fuzzy blocks located in different layers of the hierarchical fuzzy control system are adjusted through adaptation laws deduced from the defined Lyapunov function. The proposed hierarchical fuzzy control system reduces the number of rules and consequently the number of tunable parameters with respect to the ordinary fuzzy control system. Global boundedness of the overall adaptive system and the desired precision are achieved using the proposed adaptive control system. In this study, an adaptive hierarchical fuzzy system is used for two objectives; it can be as a function approximator or a control system based on an intelligent-classic approach. Three theorems are proven to investigate the stability of the nonlinear dynamic systems. The important point about the proposed theorems is that they can be applied not only to hierarchical fuzzy controllers with different structures of hierarchical fuzzy controller, but also to ordinary fuzzy controllers. Therefore, the proposed algorithm is more general. To show the effectiveness of the proposed method four systems (two mechanical, one mathematical and one chaotic) are considered in simulations. Simulation results demonstrate the validity, efficiency and feasibility of the proposed approach to control of nonlinear dynamic systems.

Dual-Energy Computed Tomography Characterization of Urinary Calculi: Basic Principles, Applications and Concerns

Dual-energy computed tomography (DECT) is based on obtaining 2 data sets with different peak kilovoltages from the same anatomical region, and material decomposition based on attenuation differences at different energy levels. Several DECT technologies are available such as: the dual-source CT, the fast kilovoltage-switching method, and the sandwich detectors technique. Calculi are detectable using iodine subtraction techniques. DECT also helps characterization of renal stone composition. The advanced postprocessing application enables differentiation of various renal stone types. Calculation of water content using spectral imaging is useful to diagnose urinary obstruction.

Contrast-Induced Nephropathy: Identifying the Risks, Choosing the Right Agent, and Reviewing Effective Prevention and Management Methods

With the rise in the use of intravenous iodinated contrast media for both computed tomography scan and angiographic studies, there is a greater likelihood of complications. One of the most well-known adverse effects is contrast-induced media nephropathy, which is also called contrast-induced acute kidney injury. This is third most common cause of hospital acquired acute renal failure. It is associated with an increase in morbidity, mortality, and greater financial burden on healthcare system. Because of these factors, it is important for the radiologist to not only recognize risk factors, as well as the signs and symptoms, but also to know how to manage patients appropriately.

Effect of timolol on refractive outcomes in eyes with myopic regression after laser in situ keratomileusis: a prospective randomized clinical trial

PURPOSE

To compare the effects of timolol on refractive outcomes in eyes with myopic regression after laser in situ keratomileusis (LASIK) with a control-matched group.

DESIGN

Prospective, randomized, parallel-controlled, double-masked clinical trial. A computer-generated randomization list based on random block permutation (length 4 to 8) was used for treatment allocation.

METHODS

setting: Basir Eye Center, Tehran, Iran.

PATIENT POPULATION

Of 124 eyes with myopic regression after LASIK using Technolas 217-Z, 45 eyes in each group were analyzed.

INTERVENTION

Patients were randomly assigned into either Group 1, who received timolol 0.5% eye drops, or Group 2, who received artificial tears for 6 months.

MAIN OUTCOME MEASURE

Spherical equivalent (SE) at 6 months posttreatment.

RESULTS

In Group 1, SE improved from -1.48 ± 0.99 diopter (D) before treatment to -0.88 ± 0.91 D and -0.86 ± 0.93 D 6 months after treatment and 6 months after timolol discontinuation, respectively (P < .001). In Group 2, it was -1.57 ± 0.67 D, -1.83 ± 0.76 D, and -1.91 ± 0.70 D, respectively (P < .001). SE was significantly better in Group 1 6 months after treatment and 6 months after discontinuation of treatment (P < .001 for both comparisons). There was a 0.26 D decrease in SE improvement every 4 months after the surgery in the Group 1 (P < .001).

CONCLUSIONS

Timolol application is effective for the treatment of myopic regression after LASIK compared with control group. Its effects last for at least 6 months after its discontinuation.

Synthesis and antioxidant evaluation of 4-(furan-2-yl)-6-methyl-2-thioxo-1,2,3,4-tetrahydropyrimidine-5-carboxylate esters

Biginelli-type pyrimidines contain an interesting moiety which has attracted considerable attention of medicinal chemists in the last few decades. Despite the very diverse pharmacologic effects ascribed to this kind of pyrimidines, there are few reports on the antioxidant evaluation of Biginelli pyrimidines. In this study synthesis of some novel Biginelli-type pyrimidines is reported. The prepared compounds are ester derivatives of 6-methyl-2-thioxo-1,2,3,4-tetrahydropyrimidine-5-carboxylate with a simple hetaryl group, furan, at C-4 position of the pyrimidine ring. These compounds were evaluated for free radical and H(2)O(2) scavenging activities. The reducing power of these compounds was also determined. Compound 3c was the most potent one in diphenyl picrylhydrazine scavenging activity assay with the IC(50) of 0.6 mg/ml. The results of reducing power assays proved that 3d and 3e are moderate reducing agents. All of the studied compounds were very weak in scavenging hydrogen peroxide compared with gallic acid.