Camel Milk and the Prevention of Glucose Cataract, an Organ Culture Study

Purpose: To test if camel milk affects glucose-induced opacity in organ cultured rat and human lenses.Methods: Whole human and rat lenses were cultured in various media containing either 55 mM glucose, camel milk, or a combination of both glucose and milk. Some lenses were cultured in a media containing neither moiety to establish a control. Absorbance spectra of human and rat lenses were measured daily using a visible/ultraviolet light spectrometer. Lens opacities were graded by a blinded grader from photographs taken daily. Aldose reductase activity, catalase activity, glutathione and receptor for advanced glycation end products levels were assayed.Results: The optical density and light scattering intensity of human lenses cultured with glucose were higher after two to four days in organ culture compared with lenses cultured without glucose. Camel milk in the culture media attenuated the glucose-induced increase in optical density, light scattering intensity and opacity grade after two to four days for both human and rat lenses. Aldose reductase activity, catalase activity and glutathione levels were restored but the receptor for advanced glycation end products was similar in rat lenses cultured with glucose compared with those cultured with glucose and camel milk. There were no differences between the assayed moieties in human lenses cultured with glucose or glucose plus milk. Since camel milk restored rat lens glutathione levels, it is possible that camel milk may protect the lens from oxidation and significantly reduce the glucose-induced increase in light scattering of human lenses. Structurally and physiologically, rat lenses are distinct from human lenses, therefore, the rat lens data was highly variable when compared with the human lens data, highlighting the importance of using human lenses in future studies.Conclusions: Camel milk present in the organ culture medium inhibited the glucose-induced opacity in human lenses and restored the amount of glutathione to the same levels of lenses not cultured in glucose. The positive results of the current study leads to future studies to determine the moieties in camel milk that are responsible for cataract inhibition and in vivo studies involving camel milk

Human Meibum Age, Lipid–Lipid Interactions and Lipid Saturation in Meibum from Infants

Tear stability decreases with increasing age and the same signs of instability are exacerbated with dry eye. Meibum lipid compositional changes with age provide insights into the biomolecules responsible for tear film instability. Meibum was collected from 69 normal donors ranging in age from 0.6 to 68 years of age. Infrared spectroscopy was used to measure meibum lipid phase transition parameters. Nuclear magnetic resonance spectroscopy was used to measure lipid saturation. Increasing human meibum lipid hydrocarbon chain unsaturation with age was related to a decrease in hydrocarbon chain order, cooperativity, and in the phase transition temperature. The change in these parameters was most dramatic between 1 and 20 years of age. Meibum was catalytically saturated to determine the effect of saturation on meibum lipid phase transition parameters. Hydrocarbon chain saturation was directly related to lipid order, phase transition temperature, cooperativity, changes in enthalpy and entropy, and could account for the changes in the lipid phase transition parameters observed with age. Unsaturation could contribute to decreased tear film stability with age

Stoma-free Survival After Rectal Cancer Resection With Anastomotic Leakage: Development and Validation of a Prediction Model in a Large International Cohort.

Objective:To develop and validate a prediction model (STOMA score) for 1-year stoma-free survival in patients with rectal cancer (RC) with anastomotic leakage (AL).Background:AL after RC resection often results in a permanent stoma.Methods:This international retrospective cohort study (TENTACLE-Rectum) encompassed 216 participating centres and included patients who developed AL after RC surgery between 2014 and 2018. Clinically relevant predictors for 1-year stoma-free survival were included in uni and multivariable logistic regression models. The STOMA score was developed and internally validated in a cohort of patients operated between 2014 and 2017, with subsequent temporal validation in a 2018 cohort. The discriminative power and calibration of the models' performance were evaluated.Results:This study included 2499 patients with AL, 1954 in the development cohort and 545 in the validation cohort. Baseline characteristics were comparable. One-year stoma-free survival was 45.0% in the development cohort and 43.7% in the validation cohort. The following predictors were included in the STOMA score: sex, age, American Society of Anestesiologist classification, body mass index, clinical M-disease, neoadjuvant therapy, abdominal and transanal approach, primary defunctioning stoma, multivisceral resection, clinical setting in which AL was diagnosed, postoperative day of AL diagnosis, abdominal contamination, anastomotic defect circumference, bowel wall ischemia, anastomotic fistula, retraction, and reactivation leakage. The STOMA score showed good discrimination and calibration (c-index: 0.71, 95% CI: 0.66-0.76).Conclusions:The STOMA score consists of 18 clinically relevant factors and estimates the individual risk for 1-year stoma-free survival in patients with AL after RC surgery, which may improve patient counseling and give guidance when analyzing the efficacy of different treatment strategies in future studies