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Biiographies of contributors to CPI Special Issue Post-Humanism: A Desire for a New Humanity. (Part I).

PURPOSE Pelvic incidence (PI) is a position independent parameter used to quantify spinopelvic sagittal balance. PI is generally measured on lateral radiographs, but more recent studies have suggested better accuracy with standard CT scans versus three-dimensional (3D) CT scans. This study compares PI obtained from lateral XR, standard CT scan and CT scan with 3D reconstruction. METHODS A total of 77 subjects with lateral XRs of the pelvis or lumbosacral spine and CT scans of the pelvis were randomly selected. Pelvic incidence on lateral XRs, standard CT scans and CT scans utilizing multiplanar reconstruction were measured and compared using intraclass correlation coefficients (ICC). PI was also measured on serial images in 28 individuals using the same imaging modality within 3 years and evaluated using ICC. RESULTS Mean ± SD of PI measurements on XR, standard CT and CT with 3D reconstruction were 56° ± 13°, 53° ± 12° and 53° ± 12°, respectively, demonstrating a small but significant elevation of PI measurement on XR (P

BackgroundThe operating room can be a frightening environment for paediatric patients. This study investigated whether music medicine can mitigate preoperative anxiety in children.Materials and methodsOne hundred and fifty children undergoing general anaesthesia were randomised to listen to music of the child’s choice, lullaby music or no music before induction. Heart rates were measured in the waiting room, upon first entry into the operating room and just prior to induction.ResultsThere was no significant difference in average heart rate change from the waiting room to induction in the patient choice, lullaby and control groups. Older age was associated with higher heart rate changes between baseline and entering the operating room. Pharmacologic sedation showed a significant beneficial effect on heart rate change at induction.ConclusionUse of music medicine in the operating room does not show efficacy to reduce anxiety in children based on heart rate changes.

A poetic fragment that shows how two rocks facilitated a virtual exchange between mother and son with an accompanying photograph of two rocks.

A poetic fragment that plays with the notion of touch as a circuit that touches back and creates feedback from which one learns, also accompanied by a photograph by Chandan Suman entitled Green and Black Light.

A poetic fragment that plays with the notion of forests as having stories and not being strictly organic, accompanied by a photograph of a split leafed philodendron.

Pelvic incidence (PI) is a position independent parameter used to quantify spinopelvic sagittal balance. PI is generally measured on lateral radiographs, but more recent studies have suggested better accuracy with standard CT scans versus three-dimensional (3D) CT scans. This study compares PI obtained from lateral XR, standard CT scan and CT scan with 3D reconstruction.A total of 77 subjects with lateral XRs of the pelvis or lumbosacral spine and CT scans of the pelvis were randomly selected. Pelvic incidence on lateral XRs, standard CT scans and CT scans utilizing multiplanar reconstruction were measured and compared using intraclass correlation coefficients (ICC). PI was also measured on serial images in 28 individuals using the same imaging modality within 3 years and evaluated using ICC.Mean ± SD of PI measurements on XR, standard CT and CT with 3D reconstruction were 56° ± 13°, 53° ± 12° and 53° ± 12°, respectively, demonstrating a small but significant elevation of PI measurement on XR (P 0.001). ICC values demonstrated a higher correlation between standard CT and 3D CT (ICC 0.986), compared to XR and standard CT (ICC 0.934) and XR and 3D CT (ICC 0.937). PI measurements on repeated imaging of the same individual also demonstrated that both CT methods produced more consistent measurements (ICC 0.986 for standard CT, 0.981 for 3D CT, 0.935 for XR).Although standard XR does provide a high level of reliability, it appears to slightly overestimate PI. CT scans do provide increased reliability, with no additional benefit of 3D reconstructions over standard CT.

Purpose: To describe a case of endogenous endophthalmitis from Streptococcus dysgalactiae subspecies equisimilis in the setting of an aortic valve abscessMethods: Retrospective case report....

Objective: Endothelial dysfunction in childhood obesity may precede cerebrovascular damage and cognitive impairment in adulthood. A noninvasive proxy of microvascular health is required to identify the risk for microvascular damage in obese children. Design and Methods The associations of hippocampal volumes and global cerebral atrophy were assessed with retinal vessel caliber in 40 normal BMI controls and 62 obese age-matched nondiabetic adolescents and the contribution of inflammation, obesity, and insulin resistance to retinal vessel caliber was evaluated. Results Compared to controls, obese adolescents had smaller retinal arterioles (8.3% decrease, P < 0.05) and wider venules (5.4% increase, P < 0.01). Larger retinal arteriole diameters were associated with less global cerebral atrophy (B = −0.24 [95% confidence interval, CI: −0.48, −0.002]) and larger hippocampal volumes (B = 0.01 [95% CI: 0, 0.02]). Venule diameters (B = 84.2 [95% CI: 30.3, 138.1]) were predicted by inflammation (fibrinogen). Arteriolar diameters were predicted by insulin resistance, indicated by logHOMA (homeostatic model assessment, HOMA) values (B = −17.03 [95% CI: −28.25, −5.81)] and body mass index (BMI) (B = −.67 [95% CI: −1.09, −0.24)]. All analyses were adjusted for mean arterial pressure, sleep apnea, and vessel diameter. Conclusions Measures of brain health, BMI, and insulin resistance are associated with retinal vessel caliber. If confirmed in larger studies, retinal arteriolar caliber may serve as a possible noninvasive proxy for brain atrophy in obese adolescents, and the identification of elevated risk for cerebral microvascular disease in adulthood.

Objective To identify coexisting ocular diagnoses in a case series of eyes that developed cystoid macular edema (CME) associated with latanoprost therapy. Design Retrospective observational case series. Participants Seven eyes of seven patients who developed CME possibly associated with latanoprost treatment were studied. Intervention When these patients, all of whom were treated with latanoprost in addition to other glaucoma medications, described blurred vision or eye irritation, ocular examination revealed CME, which was confirmed by fluorescein angiography. Latanoprost was discontinued, and in three cases topical corticosteroids and nonsteroidal anti-inflammatory agents were used to treat the CME. Main outcome measures Visual acuity and intraocular pressure were determined before latanoprost use began, during therapy, and after latanoprost use ceased. In these cases, resolution of CME was documented clinically after discontinuing latanoprost. Results Clinically significant CME developed after 1 to 11 months of latanoprost treatment, with an average decrease of 3 lines in Snellen visual acuity. Intraocular pressure decreased an average of 27.9% during treatment. Cystoid macular edema was confirmed in all cases by fluorescein angiography. In these seven patients, the following coexisting ocular conditions may have placed these eyes at risk for prostaglandin-mediated blood-retinal barrier vascular insufficiency: history of dipivefrin-associated CME, epiretinal membrane, complicated cataract surgery, history of macular edema associated with branch retinal vein occlusion, history of anterior uveitis, and diabetes mellitus. In all cases, the macular edema resolved following discontinuation of latanoprost, in some instances with concomitant use of steroidal and nonsteroidal anti-inflammatory agents. Conclusions In this case series of pseudophakic, aphakic, or phakic eyes, the temporal relationships between the use of latanoprost and developing CME, and the resolution of CME following cessation of the drug, suggest an association between latanoprost and CME. In all cases, coexisting ocular conditions associated with an altered blood-retinal barrier were present.

Objective To determine the impact of insulin resistance short of diabetes on the arteriolar-to-venular ratio (AVR) and whether AVR is related to cerebral atrophy. Design Cross-sectional study. Participants Forty-six nondiabetic subjects with normal glucose tolerance and varying degrees of insulin resistance ranging in age from 43 to 77 years. Methods Insulin resistance was assessed by fasting insulin and the homeostasis model assessment. Arteriolar-to-venular ratio was determined using digital retinal photography with a nonmydriatic camera, and retinal data were analyzed using a reliable semiautomated method. Cerebral atrophy was derived by means of manual tracing and thresholding procedures on structural magnetic resonance images. Main Outcome Measures Arteriolar-to-venular ratio and cerebral atrophy. Results Hyperinsulinemia negatively impacted AVR. Furthermore, AVR was associated with cerebral atrophy. Both of these findings were independent of the effects of age and hypertension. Conclusions These novel findings indicate that insulin resistance short of diabetes and independent of age and hypertension has a negative impact on retinal vessel health. Moreover, impaired retinal vessel health related to brain atrophy also was independent of hypertension and white matter hyperintensities. Given the connections between retinal and cerebral vasculature, this may offer a partial explanation for the presence of cognitive and brain abnormalities among individuals with insulin resistance. Financial Disclosure(s) The author(s) have no proprietary or commercial interest in any materials discussed in this article.

Potential causes of drug resistance in solid tumors include genetically determined factors expressed in individual cells and those related to the solid tumor environment. Important among the latter is the requirement for drugs to penetrate into tumor tissue and to achieve a lethal concentration in all of the tumor cells. The present study was designed to characterize further the multicellular layer (MCL) method for studying drug penetration through tumor tissue and to provide information about tissue penetration for drugs used commonly in the treatment of human cancer.EMT-6 mouse mammary and MGH-U1 human bladder cancer cells were grown on collagen-coated semiporous Teflon membranes to form MCLs approximately 200 microm thick. The properties of MCLs were compared with those of tumors grown in mice from the same cells. The penetration of drugs through the MCL was evaluated by using radiolabeled drugs or analytical methods.The MCL developed an extracellular matrix containing both laminin and collagen, although there were some differences in expression of extracellular matrix proteins. Electron microscopy showed rare desmosomes in both MCL and tumors. The penetration of cisplatin, etoposide, gemcitabine, paclitaxel, and vinblastine through tissue in the MCL was slow compared with penetration through the Teflon support membrane alone.Our results suggest limited ability of anticancer drugs to reach tumor cells that are distant from blood vessels. The limited penetration of anticancer drugs through tumor tissue may be an important cause of clinical resistance of solid tumors to chemotherapy.

Background: Subfoveal choroidal neovascularization (CNV) usually is associated with a poor visual prognosis. Laser photocoagulation of certain subfoveal membranes secondary to age-related macular degeneration (ARMD) appears preferable to observation based on recent Macular Photocoagulation Study (MPS) findings but is associated with decreased vision. The authors explored the use of vitreoretinal surgical techniques as an alternative method of eradicating subfoveal CNV. Methods: After vitrectomy, a small retinotomy technique was used to extract or disconnect from the choroidal circulation subfoveal CNV in 58 eyes. There were 33 eyes with ARMD, 20 eyes with presumed ocular histoplasmosis, and 5 eyes with miscellaneous etiologies. Five eyes also received subfoveal RPE patches. Results: With limited follow-up, significant improvement in vision (defined as 2 Snellen lines) was achieved in 7 of 22 eyes with ARMD CNV removal (1 eye 20/20), 0 of 4 eyes with ARMD CNV removal and RPE patches, and 1 of 7 eyes with ARMD CNV disconnection. Significant improvement was achieved in 6 of 16 eyes with presumed ocular histoplasmosis removal and 0 of 4 eyes with presumed ocular histoplasmosis CNV disconnection. In 5 eyes with miscellaneous CNV, 2 improved (20/20 and 20/40). CNV recurred in 29%. Conclusions: Some patients with subfoveal CNV appear to benefit from surgical removal. Only rarely do eyes with ARMD improve. Longer-term follow-up and refined case selection are required before this approach can be widely recommended.