Unique paleopathology in a pre-Columbian mummy remnant from Southern Peru--severe cervical rotation trauma with subluxation of the axis as cause of death

We describe the multidisciplinary findings in a pre-Columbian mummy head from Southern Peru (Cahuachi, Nazca civilisation, radiocarbon dating between 120 and 750 AD) of a mature male individual (40-60 years) with the first two vertebrae attached in pathological position. Accordingly, the atlanto-axial transition (C1/C2) was significantly rotated and dislocated at 38° angle associated with a bulging brownish mass that considerably reduced the spinal canal by circa 60%. Using surface microscopy, endoscopy, high-resolution multi-slice computer tomography, paleohistology and immunohistochemistry, we identified an extensive epidural hematoma of the upper cervical spinal canal-extending into the skull cavity-obviously due to a rupture of the left vertebral artery at its transition between atlas and skull base. There were no signs of fractures of the skull or vertebrae. Histological and immunohistochemical examinations clearly identified dura, brain residues and densely packed corpuscular elements that proved to represent fresh epidural hematoma. Subsequent biochemical analysis provided no evidence for pre-mortal cocaine consumption. Stable isotope analysis, however, revealed significant and repeated changes in the nutrition during his last 9 months, suggesting high mobility. Finally, the significant narrowing of the rotational atlanto-axial dislocation and the epidural hematoma probably caused compression of the spinal cord and the medulla oblongata with subsequent respiratory arrest. In conclusion, we suggest that the man died within a short period of time (probably few minutes) in an upright position with the head rotated rapidly to the right side. In paleopathologic literature, trauma to the upper cervical spine has as yet only very rarely been described, and dislocation of the vertebral bodies has not been presented.

Replicative phenotyping adds value to genotypic resistance testing in heavily pre-treated HIV-infected individuals--the Swiss HIV Cohort Study

Background Replicative phenotypic HIV resistance testing (rPRT) uses recombinant infectious virus to measure viral replication in the presence of antiretroviral drugs. Due to its high sensitivity of detection of viral minorities and its dissecting power for complex viral resistance patterns and mixed virus populations rPRT might help to improve HIV resistance diagnostics, particularly for patients with multiple drug failures. The aim was to investigate whether the addition of rPRT to genotypic resistance testing (GRT) compared to GRT alone is beneficial for obtaining a virological response in heavily pre-treated HIV-infected patients. Methods Patients with resistance tests between 2002 and 2006 were followed within the Swiss HIV Cohort Study (SHCS). We assessed patients' virological success after their antiretroviral therapy was switched following resistance testing. Multilevel logistic regression models with SHCS centre as a random effect were used to investigate the association between the type of resistance test and virological response (HIV-1 RNA <50 copies/mL or ≥1.5log reduction). Results Of 1158 individuals with resistance tests 221 with GRT+rPRT and 937 with GRT were eligible for analysis. Overall virological response rates were 85.1% for GRT+rPRT and 81.4% for GRT. In the subgroup of patients with >2 previous failures, the odds ratio (OR) for virological response of GRT+rPRT compared to GRT was 1.45 (95% CI 1.00-2.09). Multivariate analyses indicate a significant improvement with GRT+rPRT compared to GRT alone (OR 1.68, 95% CI 1.31-2.15). Conclusions In heavily pre-treated patients rPRT-based resistance information adds benefit, contributing to a higher rate of treatment success.

Effect Of Yolk Testosterone On Gonadal Testosterone And Aromatase Activity In The Pre-Optic Area Of The Brain In Male Domestic C

Maternal effects are a mother¿s non-genetic contributions to development that alter phenotypic traits in offspring. Maternal effects can take the form of prenatal allocation of resources, such as the deposition of androgens into egg yolks. For example, elevated yolk testosterone increases male sexual behaviors such as copulation solicitation and courtship displays in some avian species, in addition to aggressive behaviors like pecks and intimidating postures towards same-sex competitors. However, the mechanism connecting in ovo testosterone exposure with changes in sexual and aggressive behaviors has yet to be elucidated. While testosterone released by the gonads is important in the activation of sexual behaviors, it must undergo conversion to estrogen by the enzyme aromatase in the pre-optic area (POA) of the avian brain for full expression of sexual activity. POA aromatase is also necessary for the activation of aggressive behaviors in male birds. This experiment tested the hypothesis that elevated yolk testosterone leads to changes in POA aromatase activity and levels of gonadal testosterone, as these two endocrine parameters may mediate the effect of yolk testosterone on the frequency of sexual and aggressive behaviors. The effect of elevated yolk testosterone on gonadal testosterone levels and aromatase activity in the POA of 3-day-old domestic chickens Gallus gallus domesticus was investigated. Unincubated eggs were injected with either 10 ng testosterone in 50 ¿L sesame oil (¿T chicks¿) or 50 ¿L sesame oil (¿C chicks¿). At 3 days post-hatch, gonadal testosterone content was measured after steroid extraction using an EIA, and aromatase activity in the POA was quantified by measuring the production of tritiated water from [1ß-3H]-androstenedione. I predicted that gonadal testosterone levels and brain aromatase activity would be higher in T chicks, however found no difference between treatments. Though juvenile T production peaks at 3 days post-hatch, it is possible that the reproductive systems, including the testes and POA, are not fully developed at this time.

Episodic and long-lasting Paleozoic felsic magmatism in the pre-Alpine basement of the Suretta nappe (eastern Swiss Alps)

The Suretta nappe of eastern Switzerland contains a series of meta-igneous rocks, with the Rofna Porphyry Complex (RPC) being the most prominent member. We present LA-ICP-MS U–Pb zircon data from 12 samples representing a broad spectrum of meta-igneous rocks within the Suretta nappe, in order to unravel the pre-Alpine magmatic history of this basement unit. Fine-grained porphyries and coarse-grained augengneisses from the RPC give crystallization ages between 284 and 271 Ma, which either represent distinct magma pulses or long-lasting magmatic activity in a complex magma chamber. There is also evidence for an earlier Variscan magmatic event at ~320–310 Ma. Mylonites at the base of the Suretta nappe are probably derived from either the RPC augengneisses or another unknown Carboniferous–Permian magmatic protolith with a crystallization age between 320 and 290 Ma. Two polymetamorphic orthogneisses from the southern Suretta nappe yield crystallization ages of ~490 Ma. Inherited zircon cores are mainly of late Neoproterozoic age, with minor Neo- to Paleoproterozoic sources. We interpret the Suretta nappe as mainly representing a Gondwana-derived crustal unit, which was subsequently intruded by minor Cambrian–Ordovician and major Carboniferous–Permian magmatic rocks. Finally, the Suretta nappe was thrust into its present position during the Alpine orogeny, which hardly affected the U–Pb system in zircon.

Die Mischehe in Religion, Geschichte und Statistik der Juden

von A. Tänzer. Mit e. Geleitw. von L. Maretzki

Kunst oder Schablone in Religion und Religionsgesetz

von Immanuel Plato

Safety of Prasugrel Loading Doses in Patients Pre-Loaded With Clopidogrel in the Setting of Primary Percutaneous Coronary Intervention: Results of a Nonrandomized Observational Study.

OBJECTIVES The aim of this study was to assess the safety of the concurrent administration of a clopidogrel and prasugrel loading dose in patients undergoing primary percutaneous coronary intervention. BACKGROUND Prasugrel is one of the preferred P2Y12 platelet receptor antagonists for ST-segment elevation myocardial infarction patients. The use of prasugrel was evaluated clinically in clopidogrel-naive patients. METHODS Between September 2009 and October 2012, a total of 2,023 STEMI patients were enrolled in the COMFORTABLE (Comparison of Biomatrix Versus Gazelle in ST-Elevation Myocardial Infarction [STEMI]) and the SPUM-ACS (Inflammation and Acute Coronary Syndromes) studies. Patients receiving a prasugrel loading dose were divided into 2 groups: 1) clopidogrel and a subsequent prasugrel loading dose; and 2) a prasugrel loading dose. The primary safety endpoint was Bleeding Academic Research Consortium types 3 to 5 bleeding in hospital at 30 days. RESULTS Of 2,023 patients undergoing primary percutaneous coronary intervention, 427 (21.1%) received clopidogrel and a subsequent prasugrel loading dose, 447 (22.1%) received a prasugrel loading dose alone, and the remaining received clopidogrel only. At 30 days, the primary safety endpoint was observed in 1.9% of those receiving clopidogrel and a subsequent prasugrel loading dose and 3.4% of those receiving a prasugrel loading dose alone (adjusted hazard ratio [HR]: 0.57; 95% confidence interval [CI]: 0.25 to 1.30, p = 0.18). The HAS-BLED (hypertension, abnormal renal/liver function, stroke, bleeding history or predisposition, labile international normalized ratio, elderly, drugs/alcohol concomitantly) bleeding score tended to be higher in prasugrel-treated patients (p = 0.076). The primary safety endpoint results, however, remained unchanged after adjustment for these differences (clopidogrel and a subsequent prasugrel loading dose vs. prasugrel only; HR: 0.54 [95% CI: 0.23 to 1.27], p = 0.16). No differences in the composite of cardiac death, myocardial infarction, or stroke were observed at 30 days (adjusted HR: 0.66, 95% CI: 0.27 to 1.62, p = 0.36). CONCLUSIONS This observational, nonrandomized study of ST-segment elevation myocardial infarction patients suggests that the administration of a loading dose of prasugrel in patients pre-treated with a loading dose of clopidogrel is not associated with an excess of major bleeding events. (Comparison of Biomatrix Versus Gazelle in ST-Elevation Myocardial Infarction [STEMI] [COMFORTABLE]; NCT00962416; and Inflammation and Acute Coronary Syndromes [SPUM-ACS]; NCT01000701).