Regional Guideline on the Use of Observation and Therapeutic Engagement in Adult Psychiatric Inpatient Facilities in Northern Ireland

Regional Guideline on the Use of Observation and Therapeutic Engagement in Adult Psychiatric Inpatient Facilities in Northern Ireland

Positive effects of an angiotensin II type 1 receptor antagonist in Camurati-Engelmann disease: a single case observation.

Camurati-Engelmann disease is characterized by hyperostosis of the long bones and the skull, muscle atrophy, severe limb pain, and progressive joint contractures in some patients. It is caused by heterozygous mutations in the transforming growth factor β1 (TGFβ1) believed to result in improper folding of the latency-associated peptide domain of TGFβ1 and thus in increased or deregulated bioactivity. Losartan, an angiotensin II type 1 receptor antagonist, has been found to downregulate the expression of TGFβ type 1 and 2 receptors. Clinical trials with losartan have shown a benefit in Marfan syndrome, while trials are underway for Duchenne muscular dystrophy and other myopathies associated with TGFβ1 signaling. We hypothesized that due to its anti-TGFβ1 activity, losartan might be beneficial in Camurati-Engelmann disease. This report concerns a boy who presented at age 13 years with severe limb pain and difficulty in walking. Clinical and radiographic evaluation results were compatible with Camurati-Engelmann disease and the diagnosis was confirmed by mutation analysis (c.652C > T [p.Arg218Cys]). The boy underwent an experimental treatment with losartan at a dosage of 50 mg/day, orally. During the treatment period of 18 months, the intensity and frequency of limb pain decreased significantly (as shown by a pain diary), and muscle strength improved, allowing the boy to resume walking and climbing stairs. No obvious side effects were observed. We cautiously conclude that TGFβ1 inhibition with losartan deserves further evaluation in the clinical management of Camurati-Engelmann disease.

Toxoplasma gondii: flat-mounting of retina as a new tool for the observation of ocular infection in mice.

Ocular toxoplasmosis is the principal cause of posterior uveitis and a leading cause of blindness. Animal models are required to improve our understanding of the pathogenesis of this disease. The method currently used for the detection of retinal cysts in animals involves the observation, under a microscope, of all the sections from infected eyes. However, this method is time-consuming and lacks sensitivity. We have developed a rapid, sensitive method for observing retinal cysts in mice infected with Toxoplasma gondii. This method involves combining the flat-mounting of retina - a compromise between macroscopic observation and global analysis of this tissue - and the use of an avirulent recombinant strain of T. gondii expressing the Escherichia coli beta-galactosidase gene, visually detectable at the submacroscopic level. Single cyst unilateral infection was found in six out of 17 mice killed within 28 days of infection, whereas a bilateral infection was found in only one mouse. There was no correlation between brain cysts number and ocular infection.

Deficit in memory consolidation (abnormal forgetting rate) in childhood temporal lobe epilepsy. Pre and postoperative long-term observation.

Deficits in memory consolidation have been reported in adult patients with epilepsy but, not to our knowledge, in children. We report the long-term follow-up (9 y. o. to 18 y. o.) of a boy who suffered from temporal lobe epilepsy and underwent a left temporal lobectomy with amygdalo-hippocampal resection at the age of 10. He showed an abnormal forgetting rate when trying to encode new information and a significant deficit for retrieving remote episodic memories (when compared with his twin brother), both consistent with a consolidation disorder. His memory condition slightly improved after cessation of the epilepsy, nevertheless did not normalize. No standard memory assessment could pinpoint his memory problem, hence an adapted methodology was needed. We discuss the nature of the memory deficit, its possible causes and its clinical implications.

Direct Observation of Magnetic Metastability in Individual Iron Nanoparticles

X-ray photoemission electron microscopy combined with x-ray magnetic circular dichroism is used to study the magnetic properties of individual iron nanoparticles with sizes ranging from 20 down to 8 nm. While the magnetocrystalline anisotropy of bulk iron suggests superparamagnetic behavior in this size range, ferromagnetically blocked particles are also found at all sizes. Spontaneous transitions from the blocked state to the superparamagnetic state are observed in single particles and suggest that the enhanced magnetic energy barriers in the ferromagnetic particles are due to metastable, structurally excited states with unexpected life times

Direct Observation of Magnetic Metastability in Individual Iron Nanoparticles

X-ray photoemission electron microscopy combined with x-ray magnetic circular dichroism is used to study the magnetic properties of individual iron nanoparticles with sizes ranging from 20 down to 8 nm. While the magnetocrystalline anisotropy of bulk iron suggests superparamagnetic behavior in this size range, ferromagnetically blocked particles are also found at all sizes. Spontaneous transitions from the blocked state to the superparamagnetic state are observed in single particles and suggest that the enhanced magnetic energy barriers in the ferromagnetic particles are due to metastable, structurally excited states with unexpected life times

Pregabalin in patients with primary brain tumors and seizures: a preliminary observation.

OBJECTIVES: Patients with brain tumors and seizures should be treated with non-enzyme-inducing antiepileptic drugs (AED). Some of the newer drugs seem particularly suited in these patients. METHODS: Here we describe our experience with pregabalin (PGB); its effectiveness was retrospectively studied in nine consecutive patients with primary brain tumors and seizures. RESULTS: Six subjects had secondarily generalized and three simple partial seizures. Patients mostly suffered from WHO grade IV gliomas. PGB replaced enzyme inducing, inefficacious or bad tolerated AED, as add-on or monotherapy. Median follow-up was 5 (2-19) months; three patients died of their tumor. Daily median dosage was 300 mg. All subjects experienced at least a 50% seizure reduction, six were seizure-free. Side effects were reported in four patients, leading to PGB discontinuation in two. CONCLUSION: PGB appears to have a promising effectiveness in this setting, even as a monotherapy. Based on these results we embarked on a prospective controlled trial.

Observation of a continuous interior crisis in the Hindmarsh-Rose neuron model.

Interior crises are understood as discontinuous changes of the size of a chaotic attractor that occur when an unstable periodic orbit collides with the chaotic attractor. We present here numerical evidence and theoretical reasoning which prove the existence of a chaos-chaos transition in which the change of the attractor size is sudden but continuous. This occurs in the Hindmarsh¿Rose model of a neuron, at the transition point between the bursting and spiking dynamics, which are two different dynamic behaviors that this system is able to present. Moreover, besides the change in attractor size, other significant properties of the system undergoing the transitions do change in a relevant qualitative way. The mechanism for such transition is understood in terms of a simple one-dimensional map whose dynamics undergoes a crossover between two different universal behaviors

Geological observation in southeastern Zanskar and adjacent Lahul area (northern Himalaya).

The paper deals with the stratigraphic and structural setting of the sedimentary sequence cropping out in southeastern Zanskar and adjacent Lahul areas. The Tibetan Zone succession of southeastern Zanskar consists of about 6000 m of sediments, Late Precambrian~ ?Eocene in age, arranged in two superposed slabs (Pugh tal Unit, below, and Zangla Unit, above) tectonically resting upon the High Himalayan Crystalline. The Pughtal sequence, mostly terrigenous with carbonate units in the Cambrian, Silurian and Carboniferous, is about 2500 m thick. It was deposited from ?Late Precambrian to Carboniferous or ?Early Permian. The Permian Panjal Traps constitute the "sole" of the Zangla Unit, whose sedimentary sequence, about 3000 m thick, mainly carbonatic, spans from Late Permian (Kuling Formation) to Middle Jurassic (Kioto Limestone) in eastern Zanskar. In the Zangla area Late Jurassic/Cretaceous formations (Spiti Shales, Giumal Sandstone, Chikkim Limestone) are also present. Towards northwest, the sequence ranges up to Paleocene (Spanboth Formation) and ?Eocene (Chulung La Slates). Au nord de la Haute Chaine, dans la partie septentrionale de I'Himalaya, la marge continentale indienne a vu plus de 6000 m de sediments se deposer depuis I'Infracambrien jusqu'a I'Eocene. Lors de l'orogenese himalayenne, ces sediments ont ete decolles de leur substratum originel, dMormes et metamorphises de maniere differenciee suivant leur position. Ils reposent en contact tectonique sur la nappe cristalline du Haut-Himalaya. L'unite inferieure ou unite de Pughtal consiste, la ou elle est complete, en plus de 2500 m de sediments en partie detritiques terrigenes mais marque par l'edification de plates-formes carbonatees au Cambrien, Silurien et Carbonifere. Dans cette unite on releve deux grandes sequences sedimentaires separees par l'evenement epirogenique et magmatique tardi-Cambrien (500 rna), contrecoup de l'orogenese pan-africaine. Un niveau massif de vo1canites basaltiques permiennes ~ les Panjal Traps ~ forme la base ou sole de I'unite superieure (nappe de Zangla). Cette unite, plissee de maniere disharmonique, recouvre progressivement vers l'ouest des niveaux de plus en plus anciens de l'unite inferieure, niveaux eux-memes replisses en grands plis couches kilometriques a vergence nord. Dans la partie occidentale (Ringdom) l'unite superieure repose directement sur la nappe cristalline. Cette unite montre une serie sedimentaire avec des carbonates de plate-forme bien developpes au Trias superieur et au Lias puis des sediments surtout pelagiques et en partie detritiques terrigenes au Jurassique superieur et au Cretace. Des la fin du Cretace et jusqu'au Paleocene superieur s'edifie a nouveau une plate-forme peu profonde. La serie se termine par des couches continentales attribuees a l'Eocene. L'evolution geodynamique durant Ie Paleozoique et Ie Mesozoique est analysee. II en ressort que la sedimentation, a partir de I'Ordovicien, est regJee plus par des grands cycles eustatiques que par des mouvements tectoniques ou epirogeniques regionaux (les orogeneses caledoniennes, hercyniennes et cretacees des auteurs).

Store-operated Ca2+ Entry Mediated by Orai1 and TRPC1 Participates to Insulin Secretion in Rat β-Cells.

Store-operated Ca(2+) channels (SOCs) are voltage-independent Ca(2+) channels activated upon depletion of the endoplasmic reticulum Ca(2+) stores. Early studies suggest the contribution of such channels to Ca(2+) homeostasis in insulin-secreting pancreatic β-cells. However, their composition and contribution to glucose-stimulated insulin secretion (GSIS) remains unclear. In this study, endoplasmic reticulum Ca(2+) depletion triggered by acetylcholine (ACh) or thapsigargin stimulated the formation of a ternary complex composed of Orai1, TRPC1, and STIM1, the key proteins involved in the formation of SOCs. Ca(2+) imaging further revealed that Orai1 and TRPC1 are required to form functional SOCs and that these channels are activated by STIM1 in response to thapsigargin or ACh. Pharmacological SOCs inhibition or dominant negative blockade of Orai1 or TRPC1 using the specific pore mutants Orai1-E106D and TRPC1-F562A impaired GSIS in rat β-cells and fully blocked the potentiating effect of ACh on secretion. In contrast, pharmacological or dominant negative blockade of TRPC3 had no effect on extracellular Ca(2+) entry and GSIS. Finally, we observed that prolonged exposure to supraphysiological glucose concentration impaired SOCs function without altering the expression levels of STIM1, Orai1, and TRPC1. We conclude that Orai1 and TRPC1, which form SOCs regulated by STIM1, play a key role in the effect of ACh on GSIS, a process that may be impaired in type 2 diabetes.

Observation and Observing in Economics

Two themes are generative for revealing and understanding the history of observation in economics. First, we argue for the importance of noting that observation is an activity as well as a result, and second that observation is no more identical with quantification than observing is with measuring. These two themes enable us to discuss different historical dimensions of the ways in which economists have observed their economies and so enlarge our understanding of their observational practices. These problematics especially help in delineating the intricate, multilayered, and active interactions between the observer and the observed that take place in all social science observation, and from which our pictures of the economic world emerge.

Aerosol therapy in intensive and intermediate care units: prospective observation of 2808 critically ill patients.

PURPOSE: Unlike in the outpatient setting, delivery of aerosols to critically ill patients may be considered complex, particularly in ventilated patients, and benefits remain to be proven. Many factors influence aerosol delivery and recommendations exist, but little is known about knowledge translation into clinical practice. METHODS: Two-week cross-sectional study to assess the prevalence of aerosol therapy in 81 intensive and intermediate care units in 22 countries. All aerosols delivered to patients breathing spontaneously, ventilated invasively or noninvasively (NIV) were recorded, and drugs, devices, ventilator settings, circuit set-up, humidification and side effects were noted. RESULTS: A total of 9714 aerosols were administered to 678 of the 2808 admitted patients (24 %, CI95 22-26 %), whereas only 271 patients (10 %) were taking inhaled medication before admission. There were large variations among centers, from 0 to 57 %. Among intubated patients 22 % (n = 262) received aerosols, and 50 % (n = 149) of patients undergoing NIV, predominantly (75 %) inbetween NIV sessions. Bronchodilators (n = 7960) and corticosteroids (n = 1233) were the most frequently delivered drugs (88 % overall), predominantly but not exclusively (49 %) administered to patients with chronic airway disease. An anti-infectious drug was aerosolized 509 times (5 % of all aerosols) for nosocomial infections. Jet-nebulizers were the most frequently used device (56 %), followed by metered dose inhalers (23 %). Only 106 (<1 %) mild side effects were observed, despite frequent suboptimal set-ups such as an external gas supply of jet nebulizers for intubated patients. CONCLUSIONS: Aerosol therapy concerns every fourth critically ill patient and one-fifth of ventilated patients.

The internal wave field in Sau reservoir : Observation and modeling of a third vertical mode

Water withdrawal from Mediterranean reservoirs in summer is usually very high. Because of this, stratification is often continuous and far from the typical two-layered structure, favoring the excitation of higher vertical modes. The analysis of wind, temperature, and current data from Sau reservoir (Spain) shows that the third vertical mode of the internal seiche (baroclinic mode) dominated the internal wave field at the beginning of September 2003. We used a continuous stratification two-dimensional model to calculate the period and velocity distribution of the various modes of the internal seiche, and we calculated that the period of the third vertical mode is ;24 h, which coincides with the period of the dominating winds. As a result of the resonance between the third mode and the wind, the other oscillation modes were not excited during this period