Deep brain stimulation in Parkinson's disease: analysis of the variation in final stimulating lead placement based on multi-tract electrode recordings

Background: Deep brain stimulation (DBS) of the subthalamic nucleus (SNT) is a treatment modality for Parkinson's Disease (PD). Either single central trajectory tract or multiple selected trajectory tracts based on microelectrode recordings (MER) are used for the placement of the final stimulating electrodes. This study aims to explore how many times trajectory tracts, other than the central tract are used for final lead placement.Methods: Retrospective analysis of a randomly selected convenience sample of 24 subjects from patients who had DBS by a single neurosurgeon. After MRI and CT assessment, planning using a stereotactic frame for variable trajectory placement of temporary electrodes and MER that was the basis for site and tract selection for the final electrode placements used for DBS. Results: Twenty four patients had 47 DBS electrodes placed: 1 unilateral and 23 bilateral. The central tract was used in 45 (95.75%) of these cases. The central trajectory tract accounted for 30 (63.83%), the anterior trajectory tract for 7 (14.89%), the medial tract for 5 (10.64%), the posterior for 4 (8.51%) and the lateral for 1 (2.13%) of final lead placements. Conclusion: The results of this study based on the predicted best stimulating sites following MER show that alternates to the central trajectory tract are required in 37% of site placements. A comparative study exploring clinical benefit is required to assess if variable electrode trajectory placement based on accurate physiological measurements is superior to single central trajectory placement

Assessing Lead Levels in Occupational Health : a Mini-Review

Lead is a well-established toxin that continues to pose a health risk. Blood lead levels (BLLs) and urinary chelatable lead are the tests of choice for assessing acute and chronic toxicity. We highlight some of the other tests available. As occupational exposure to lead is often accompanied by other toxic heavy metal exposure; measuring whole blood heavy metal levels should be considered for workers with chronically elevated BLLs

The Assessment of Heavy Metal and By-Product on Fried Food Sold by Roadside Vendors in Calabar; Nigeria

The assessment of heavy metals (lead and mercury) and by-product (sulphur) on fried food sold by roadside food vendors in Calabar; Nigeria were investigated. The food samples which were covered and uncovered after frying were obtained randomly from 20 street food vendors. The food samples were obtained from 10 busy roads and 10 non- busy roads in Calabar; Nigeria. The busy roads were those roads that recorded more than 20 cars per minute; while the non-busy roads recorded less than 10 cars per minute. The result showed that the busy roads had significant (P0.05) higher depositions of heavy metals and by-products than the non-busy roads. Lead deposits on the food samples was significantly (P0.05) higher than the amount of mercury and significantly (P0.05) higher than the amount of sulphur deposit. The amount of sulphur deposit on the food samples was significantly higher (P0.05) than mecury. The food samples that was uncovered after frying had a significantly higher (P0.05) deposit of heavy metal and by-product than the food samples that were covered after frying. This result suggest that fried foods vended in calabar by the road-side have a serious public health concern