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

Charlson comorbidity index applied to shunted idiopathic normal pressure hydrocephalus

Abstract A series of epidemiological studies have shown the limited life expectancy of patients suffering from idiopathic normal pressure hydrocephalus (iNPH). In most cases, comorbid medical conditions are the cause of death, rather than iNPH. Though it has also been shown that shunting improves both life quality and lifetime. We sought to investigate the utility of the Charlson comorbidity index (CCI) for improved preoperative risk–benefit assessment of shunt surgery in individual iNPH cases. 208 shunted iNPH cases were prospectively investigated. Two in-person follow up visits at 3 and 12 months assessed postoperative clinical status. The correlation of the age adjusted CCI with survival was investigated over the median observation time of 2.37 years (IQR 1.16–4.15). Kaplan Meier statistics revealed that patients with a CCI score of 0–5 have a 5-year survival rate of 87%, compared to only 55% in patients with CCI > 5. Cox multivariate statistics revealed that the CCI was an independent predictor of survival, while common preoperative iNPH scores (modified Rankin Scale (mRS), gait score, and continence score) are not. As expected, mRS, gait, and continence scores improved during the postoperative follow up period, though relative improvement on any of these was not predicted by baseline CCI. The CCI is an easily applicable preoperative predictor of survival time in shunted iNPH patients. The lack of a correlation between the CCI and functional outcome means that even patients with multiple comorbidities and limited remaining lifetime may appreciate benefit from shunt surgery

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