Synthetic Heroin-Induced Parkinsonism

Parkinson\u27s disease is a slowly progressive, neurodegenerative disorder affecting one in 1,000 of the general population; its incidence increases with age, but the cause remains unknown. The disease is characterized pathologically by a loss of neurons from the pigmented substantia nigra pars compacta, and a triad of physical symptoms of rigidity, tremor, and bradykinesia or akinesia . Thus the clinical condition of Parkinson\u27s disease is a rather complex disorder with a variety of physical symptoms due to neuronal damage in a number of brain regions. Additional brain regions also affected in clinical Parkinson\u27s disease include the ventral tegmental area, locus coeruleus, serotonergic dorsal raphe system, and the dorsal motor nucleus of the vagus ( I) . Furthermore, it has been suggested that damage to these various regions of the brain leads to a variety of motor and mental disorders (depression and dementia) that are specific to the damage in each of these neuronal systems (2) . Loss of norepinephrine may lead to depression; the incidence of depression varies between 20 to 90 percent in Parkinson\u27s disease, and many of these patients show favorable responses to tricyclic antidepressants

Feasibility of diagnosis of postcardiotomy tamponade by miniaturized transesophageal echocardiography.

BACKGROUND: Pericardial tamponade after cardiac surgery is a critical diagnosis that can be difficult to diagnose using conventional cardiac monitoring. Transesophageal echocardiography can provide comprehensive information to make the diagnosis but is not always available, whereas transthoracic echocardiography has its utility limited because of the body habitus or other surgical effects. New monitoring devices, miniaturized hemodynamic transesophageal echocardiography (hTEE), which allows point of care assessment of cardiac filling and functions, may aid in diagnosis of postcardiotomy tamponade. METHODS: From May 2011 to July 2013, 21 patients underwent hTEE to rule out pericardial tamponade for clinical suspicion of tamponade after open heart surgery. The hTEE images were reviewed, and the patient outcomes were analyzed. RESULTS: Nine patients showed no evidence of pericardial collection and did not require reexploration. Two patients showed a presence of small hematoma without ventricular compression and also did not undergo exploration. Ten patients were positive for pericardial tamponade (effusion or hematoma with ventricular compression); eight of these cases underwent emergent surgical exploration. Of the two patients who did not undergo immediate reoperation, one was managed by chest tube manipulation and the other patient underwent subsequent surgical exploration after his extensive coagulopathy was corrected by medical treatment. CONCLUSIONS: The diagnosis of pericardial tamponade postcardiotomy is feasible using a disposable hTEE based on our limited experience. We avoided unnecessary explorations while concomitantly made prompt diagnosis in emergent situations. The hTEE device was a valuable tool in hemodynamic management in the intensive care unit, allowing rapid evaluations

Incidence of, predictors for, and mortality associated with malignant ventricular arrhythmias in non-ST elevation myocardial infarction patients.

BACKGROUND: The incidence of non-ST elevation myocardial infarction (NSTEMI) is increasing. Although life-threatening ventricular arrhythmias have been well-documented in patients with ST elevation MI (STEMI), their incidence and importance in NSTEMI have not been examined in similar detail. We examined the incidence, predictors, and mortality rates of ventricular arrhythmias in a cohort of NSTEMI patients undergoing an early invasive strategy. METHODS: Consecutive patients admitted with NSTEMI who underwent cardiac catheterization within 48 h of admission were identified by chart review. Presence and type of ventricular arrhythmias and 30-day mortality were recorded. Malignant arrhythmias were defined as sustained ventricular tachycardia (VT, \u3e100 beats/min lasting \u3e30 s) or fibrillation (VF). Clinical risk factors, laboratory values, findings on electrocardiogram, echocardiogram, cardiac catheterization, and revascularization procedure data were recorded. RESULTS: VT/VF occurred in 21 (7.6%) of 277 NSTEMI patients. Sixty percent of these events occurred within the first 48 h after hospital admission, with a median occurrence at 72 h. Twelve patients (4.3%) required defibrillation. Troponin levels were higher and left ventricular ejection fraction was lower in the VT/VF group. Multivariable analysis also identified the presence of left bundle branch block and need for urgent coronary artery bypass grafting as significant predictors of malignant ventricular arrhythmias. Thirty-day mortality was significantly higher in NSTEMI patients with malignant ventricular arrhythmias than without (38 vs. 3%, P\u3c0.001). CONCLUSION: Despite an early invasive strategy, malignant ventricular arrhythmias are frequent in NSTEMI patients and are associated with increased 30-day mortality

Structure-function analysis of the Bacillus megaterium GerUD spore germinant receptor protein.

Germination of Bacillus spores is triggered by the interaction of germinant molecules with specialized receptor proteins localized to the spore inner membrane. Germinant receptors (GRs) are comprised typically of three interacting protein subunits, each of which is essential for receptor function. At least some GRs appear to have a fourth component, referred to as a D-subunit protein. A number of D-subunit proteins were shown previously to be capable of modulating the activity of associated GRs. Here, we investigate the topology and structure-function relationships of the Bacillus megaterium QM B1551 GerUD protein, which is associated with the GerU GR. The presented data demonstrate that GerUD can be subjected to relatively extensive structural modifications while retaining function. Indeed, the presence of either of the two transmembrane spanning domains is sufficient to modulate an efficient GerU-mediated germinative response. The precise function of D-subunit proteins has yet to be established, although they may act as molecular chaperones within the spore inner-membrane environment.S.G was the recipient of a RA Fisher bursary award from Gonville and Caius College, University of Cambridge. X.Z is the recipient of an EPSRC Doctoral Training Grant.This is the final version of the article. It was first available from OUP via http://dx.doi.org/10.1093/femsle/fnv21

Skills of different mesoscale models over Indian region during monsoon season: Forecast errors

Performance of four mesoscale models namely, the MM5, ETA, RSM and WRF, run at NCMRWF for short range weather forecasting has been examined during monsoon-2006. Evaluation is carried out based upon comparisons between observations and day-1 and day-3 forecasts of wind, temperature, speci.c humidity, geopotential height, rainfall, systematic errors, root mean square errors and specific events like the monsoon depressions. It is very difficult to address the question of which model performs best over the Indian region? An honest answer is 'none'. Perhaps an ensemble approach would be the best. However, if we must make a final verdict, it can be stated that in general, (i) the WRF is able to produce best All India rainfall prediction compared to observations in the day-1 forecast and, the MM5 is able to produce best All India rainfall forecasts in day-3, but ETA and RSM are able to depict the best distribution of rainfall maxima along the west coast of India, (ii) the MM5 is able to produce least RMSE of wind and geopotential fields at most of the time, and (iii) the RSM is able to produce least errors in the day-1 forecasts of the tracks, while the ETA model produces least errors in the day-3 forecasts

Removal of hexavalent chromium of contaminated soil by coupling electrokinetic remediation and permeable reactive biobarriers

PURPOSE: In this study, a novel and ecological alternative have been developed to treat soils contaminated with hexavalent chromium coupling two well-known systems: electrokinetic remediation and permeable reactive biobarriers. The electric field promotes the electromigration of the hexavalent chromium oxyanions towards the anode. The biobarriers were placed before the anode electrode, in order to promote the reduction and retention of the chromium migrating in its direction. Thus, this technology provided a global treatment to soil removal without subsequent treatments of the contaminated effluents. METHODS: The electrokinetic system was coupled with two different permeable reactive biobarriers composed by Arthrobacter viscosus bacteria, supported either in activated carbon or zeolite. An electric field of 10 V was applied and two different treatment times of 9 and 18 days were tested. RESULTS: Removal values of 60% and 79% were obtained when electrokinetic treatment was coupled with zeolite and activated carbon biobarriers, respectively, for a test period of 18 day. The reduction of hexavalent chromium to trivalent chromium was around 45% for both systems. CONCLUSIONS: In this work, two types of biobarriers were efficiently coupled to electrokinetic treatment to decontaminate soil with Cr(VI). Furthermore, the viability of the new coupling technology developed (electrokinetic + biobarriers) to treat low-permeability polluted soils was demonstrated.This work was supported by the Spanish Ministry of Science and Innovation (CTQ2008-03059/PPQ), Xunta de Galicia (08MDS034314PR). The authors are grateful to the Spanish Ministry of Science and Innovation for providing financial support for Marta Pazos under the Ramon y Cajal program and the Fundacao para a Ciencia e Tecnologia, Ministerio da Ciencia e Tecnologia, Portugal through the PhD grant of Bruna Fonseca (SFRH/BD/27780/2006)