(photo credit: ILAN SHOCHAT)
Never put the cap of a stick-pencil or -pen into your mouth. That is the lesson learned by an eight-and-a-half- year-old boy – and good advice for every child and adult – who nearly died when the mechanical lead pencil cap he sucked on entered his lung and punctured it.
Rehovot doctors at Kaplan Medical Center’s pediatric intensive care unit (headed by Dr. Eli Shapiro) pulled the cap out from the bottom of his lung in surgery in which he was anesthetized and attached to a respirator.
Lidor, a resident of Yavneh, was rushed to the hospital, where doctors saw that his lung had collapsed due to the puncture. His mother was alerted by a phone call from his school that he had been choking on the cap and was hospitalized.
“I prayed silently all the way to Kaplan, where doctors said he had difficulty breathing and had to go to the operating room to save him. Lidor is not in the intensive care unit, and doctors hope he will be able to return to a normal routine.”
Lung expert Dr. Avi Hevroni said that the shape of the cap caused it to sink to the bottom of the lung and cause the puncture. Not only did his lung collapse, but his neck became very swollen. The surgeons used a tiny balloon usually utilized for angioplasty, inflated it with air and managed to pull the cap out whole.
“This was an unconventional treatment for an unconventional problem,” said Hevroni.
Some years ago, manufacturers of stick pens and mechanical pencils were required to make holes in the caps to allow air to enter if it is stuck in the trachea, but this does not work effectively when the caps are lodged in the lungs.END TO READING GLASSES?
Will people over 40 suffering from presbyopia who need reading glasses for magnification soon be freed from having to wear them? A thin ring inserted into the eye could in the near future relieve the blurriness in near vision experienced by many people over the age of 40, according to a study released today at the 118th annual meeting of the American Academy of Ophthalmology. A corneal inlay device currently undergoing clinical review in the US improved near vision well enough for 80 percent of the participating patients to read a newspaper without disturbing far distance vision needed for daily activities like driving.
Presbyopia affects more than a billion people worldwide.
As people age, the cornea becomes less flexible and bends in such a way that it becomes difficult to see up close. While the most common remedy is wearing reading glasses, a host of new corneal inlay products are in development to treat the condition, with three types currently under review by the US Food and Drug Administration.
The theoretical advantage of using corneal inlays instead of wearing reading glasses is that corneal inlays prevent the need for constantly putting on and taking off glasses, depending on whether the person needs to see near or far.
One of the devices is the KAMRA inlay, a thin, flexible ring that measures 3.8 millimeters in diameter, with a 1.6 millimeter hole in the middle. When dropped into a small pocket in the cornea covering the front of the eye, the device acts like a camera aperture, adjusting the depth of field so that the viewer can see near and far. The procedure to insert the implant is relatively quick, lasting about 10 minutes and requires only topical anesthesia.
To test the inlay’s efficacy, clinicians conducted a prospective non-randomized study of 507 patients 45 to 60 years of age with presbyopia (who were not nearsighted) living in the US, Europe and Asia. The researchers implanted the ring in the patients and followed up with them over the course of three years.
In 83% of eyes with the implant, one type of corneal inlay allowed presbyopic patients to see with 20/40 vision or better over the three years. This is considered the standard for being able to read a newspaper or drive a vehicle without corrective lenses. The benefits did not decline over the three-year study.
Complications from corneal inlays in general have included haziness that is treatable with steroids; however, improvements in inlay design have made the effect less common. If necessary, inlays can be removed, making it a reversible treatment, unlike other procedures such as LASIK for presbyopia.
The device is already sold in parts of Asia, Europe and South America, but is not yet approved by the FDA for use in the US.
SUPERCOMPUTERS AID DRUG DESIGN
The youngest medical school – Bar-Ilan University’s Galilee Medical Faculty in Safed – has opened a new structural and computational biology lab where it is formulating new drugs using computer imaging. Dr. Avraham Samson, a bioinformatics expert by training, heads the lab, which is conducting molecular simulations of the movement of proteins.
These demonstrate the way the protein folds within a structure and how drugs combine with it. At present, he and his team are working on the development of new drugs to fight cancer and Alzheimer’s disease. The experimental drug against the dementia disease has shown good results and shown improvement in the memories of Alzheimer’s patients, he said. His lab recently received a grant from the European Community for its research.
Samson is also busy with a project aimed at treatment of head trauma together with Prof. Jean Soustiel, head of neurosurgery at the Western Galilee Medical Center in Nahariya. In such injuries, healthy tissue is damaged by nearby tissues that have suffered trauma. While there is no way to prevent this yet, the researchers are developing a drug that would save the healthy ones from being affected by the damaged ones.To accomplish this, they are using a supercomputer called Ahlama with processors that that carry out calculations and observe molecular movement so few lab animals have to be tested.