Polydipsia and intermittent hyponatremia

Introduction

Hyponatraemia occurs in 4% of schizophrenic patients. Dilutional hyponatraemia, due to inappropriate retention of water and excretion of sodium, occurs with different psychotropic medications and could lead to hippocampal dysfunction. This complication is usually asymptomatic but can cause severe problems, as lethargy and confusion, difficult to diagnose in mentally ill patients.

Objectives

To describe a case of a patient with psychotropic poli-therapy, admitted three times due to hyponatremia and the pharmacological changes that improved his condition.

Aims

To broadcast the intermittent hyponatraemia and polydipsia (PIP), a not rare condition, suffered by treated schizophrenic patients and discuss its physiopathology and treatment thorough a case report.

Methods

A 56-year schizophrenic male was admitted for presenting disorganized behavior, agitation, auditory hallucinations, disorientation, ataxia, vomits and urinary retention. He was on clomipramine, haloperidol and clotiapine (recently added), quetiapine, fluphenazine and clonazepam. After water restriction his symptoms improved and he was discharged. Twenty-five days later, he was readmitted for presenting the same symptoms and after water restriction, he was discharged. Five days later, he was again admitted and transferred to the psychiatric ward.

Results

Haloperidol, fluphenazine and clomipramine were replaced by clozapine. These changes lead him to normalize the hypoosmolality and reduce his water-voracity. Endocrinology team did not label this episode of SIADH due to its borderline blood and urine parameters.

Conclusions

Hyponatremia is frequent in schizophrenic patients and may have severe consequences. Therefore, a prompt recognition and treatment is warranted.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Low phase noise beams for Raman transitions with a phase modulator and a highly birefringent crystal

We present a technique to excite Raman transitions with minimum phase noise. A phase modulator generates the Raman beams and a long calcite crystal rotates the polarization of the sidebands by 90° with respect to the carrier. That polarization converts the destructive interference of the Raman pairs into constructive interference, opening the possibility to drive both co-propagating and counter-propagating transitions at high detuning with the same setup. The technique has low phase noise and a low sensitivity to vibrations or temperature fluctuations. We apply it to drive velocity insensitive Raman transitions. The crystal can be also configured to filter out one of the sidebands.

Synthesis and characterization of extremely small gold nanoshells, and comparison of their photothermal conversion capacity with gold nanorods

The current methods for preparing gold nanoshells (AuNSs) produce shells with a diameter of approximately 40 nm or larger, with a relatively large polydispersity. However, AuNSs with smaller diameters and more monodispersity are better suited for biomedical applications. In this work, we present a modified method for the preparation of AuNSs, based on the use of sacrificial silver nanoparticles (AgNPs). We customized the Lee-Meisel method to prepare small and monodisperse AgNPs that were used as sacrificial nanoparticles to prepare extremely small monodispersed AuNSs with an average diameter from 17 to 25 ± 4 nm. We found that these AuNSs are faceted, and that the oxidized silver likely dissolves out of the nanoparticles through some of the facets on the AuNSs. This leads to a silver oxide plug on the surface of the AuNSs, which has not been reported before. The smaller AuNSs, prepared under the best conditions, absorb in the near infrared region (NIR) that is appropriate for applications, such as photothermal therapy or medical imaging. The AuNSs showed absorption peaks in the NIR similar to those of gold nanorods (AuNRs) but with better photothermal capacity. In addition, because of their negative charge, these AuNSs are more biocompatible than the positively charged AuNRs. The synthesis of small, monodisperse, stable and biocompatible nanoparticles, like the ones presented in this work, is of prime importance in biomedical applications.

Advancing the public health role of midwives and maternity support workers

Midwives are crucial to enhancing public health and wellbeing. Caring for families throughout the childbearing continuum offers midwives the perfect opportunity to address many public health agendas. All aspects of midwifery care can influence health outcomes and, as such, it is essential that all midwives embrace their public health role. In this article you will be encouraged to advance your public health role by exploring key midwifery directives regarding public health agendas; examining the outcomes of recent surveys and work conducted by the Royal College of Midwives (RCM), in the United Kingdom (UK); and reviewing ways to develop our public health role from a range of perspectives within maternity services.

Influence of oxygen transfer on Pseudomonas putida effects on growth rate and biodesulfurization capacity

The growth rate and desulfurization capacity accumulated by the cells during the growth of Pseudomonas putida KTH2 under different oxygen transfer conditions in a stirred and sparged tank bioreactor have been studied. Hydrodynamic conditions were changed using different agitation conditions. During the culture, several magnitudes associated to growth, such as the specific growth rate, the dissolved oxygen concentration and the carbon source consumption have been measured. Experimental results indicate that cultures are influenced by the fluid dynamic conditions into the bioreactor. An increase in the stirrer speed from 400 to 700 rpm has a positive influence on the cell growth rate. Nevertheless, the increase of agitation from 700 to 2000 rpm hardly has any influence on the growth rate. The effect of fluid dynamics on the cells development of the biodesulfurization (BDS) capacity of the cells during growth is different. The activities of the intracellular enzymes involved in the 4S pathway change with dissolved oxygen concentration. The enzyme activities have been evaluated in cells at several growth time and different hydrodynamic conditions. An increase of the agitation from 100 to 300 rpm has a positive influence on the development of the overall BDS capacity of the cells during growth. This capacity shows a decrease for higher stirrer speeds and the activity of the enzymes monooxygenases DszC and DszA decreases dramatically. The highest value of the activity of DszB enzyme was obtained with cells cultured at 100 rpm, while this activity decreases when the stirrer speed was increased higher than this value.

97 ONE-DAY PROTEIN-FREE CULTURE SELECTS FOR BOVINE BLASTOCYSTS WITH IMPROVED LONG-TERM VIABILITY AFTER VITRIFICATION

Single embryo culture in SOF with BSA allows efficient noninvasive analysis of culture medium (CM). Defined protein-free CM avoids contaminants present in commercial BSA. In this work we studied the performance of a single culture step with and without protein. In vitro-matured and -fertilized oocytes were cultured in SOF+6 mg mL–1 BSA. From Day-6 onwards, n = 1351 morulae and early blastocysts were singly cultured in 12 µL SOF+6 mg mL–1 BSA or 0.5 mg mL–1 polyvinyl-alcohol (PVA; 20 replicates). Development was recorded as % Day-6 cultured embryos. Day-7 and Day-8 expanded blastocysts were vitrified and cultured upon warming in SOF+10% FCS for 48 h. Expression of genes of stress, metabolism, and imprinting was measured by RT-qPCR in Day-7 fresh expanded and in vitrified/warmed hatched blastocysts. Day-7 vitrified blastocysts were allowed to re-expand for 2 h before embryo transfer (recipients used once or twice). Day 40 pregnancy, miscarriage and birth rates, and morphometry and weight of calves, were recorded. Data were analysed by GLM and REGWQ test. Protein removal reduced Day 7 blastocyst rate (71.3 ± 2.7 v. 51.6 ± 2.7; P < 0.0001) and tended to reduce expansion rate (46.6 ± 3.1 v. 38.4 ± 3.0; P = 0.054). Survival rates of all vitrified embryos cultured with PVA tended to increase over BSA at 2 h and 24 h after warming (97.2 ± 1.7 v. 93.6 ± 1.6; P = 0.09, and 96.4 ± 1.9 v. 91.8 ± 1.8; P = 0.07, respectively). Interestingly, almost all vitrified Day-7 embryos cultured without protein reexpanded 2 h after warming (138/139 v. 137/144 with BSA). This allows suppressing the culture period before embryo transfer. Fresh embryos cultured without protein showed higher expression of IGF2R and the ER stress genes ATF4 and DDIT3 (P < 0.03), and DNMT3A tended to increase (P = 0.062). After warming, only G6PD was overexpressed in protein-free embryos (P < 0.01). Day 40 pregnancy rates did not differ, but birth rates were higher in PVA [58% (11/19)] than in BSA [31% (14/45); P = 0.039]. Pregnancy losses from Day 40 increased with [30% (6/20)] v. without protein [8% (1/12); P = 0.034]. Calf weight, size, thorax circumference, and gestation length did not vary (P > 0.41; not shown). Protein starvation limits blastocyst development but selects for improved viability. Such a profile agrees with the quiet embryo hypothesis (Leese et al. 2008 Mol. Hum. Reprod. 14, 667–672), by which the most viable embryos use endogenous nutrients efficiently and cope with stress successfully. Differences in gene expression seen before vitrification are abolished after warming, with G6PDH perhaps reflecting superior ability of protein-free cultured embryos to counteract stress induced by cryopreservation. Without protein, more embryos reach birth as morphologically normal calves. Research was supported by MICINN (AGL2012–37772) and FEDER; AM: SENESCYT-Ecuador-II Fase 2013. The authors are members of the COST Action FA1201 (Epiconcept).

In vivo exposure of marine mussels to carbamazepine and 10-hydroxy-10,11-dihydro-carbamazepine: Bioconcentration and metabolization

Aquatic organisms are exposed to pharmaceuticals present in natural waters, but few data are available on the accumulation of these substances in such organisms. The present study evaluated the in vivo bioconcentration of two anticonvulsants--carbamazepine (CBZ) and 10-hydroxy-10,11-dihydro-carbamazepine (10 OH)--in marine mussels (Mytilus galloprovincialis) exposed to nominal 10 μg L(-1) concentrations for one week. The bioconcentration factors (BCFs) were 3.9 and 4.5 L kg(-1) dry weight (dw) for CBZ and 10 OH, respectively. CBZ accumulation reached an average tissue concentration of 29.3 ± 4.8 ng g(-1) dw, and 10 OH accumulated up to 40.9 ± 4.6 ng g(-1) dw in tissues within one week, showing first-order kinetics. BCF obtained with linear QSAR models correctly estimated the CBZ bioconcentration and overestimated the 10 OH bioconcentration to some extent. The detection of two metabolites (carbamazepine-10,11-epoxide and acridine) among the five sought suggested an active metabolism for CBZ. In contrast, none of the 10 OH metabolites were detected in mussels exposed to 10 OH. CBZ showed higher accumulation in the digestive gland, where some relevant metabolites were detected, than in other studied tissues. The implication of those findings on field biomonitoring is discussed.

Hyperfine Anomalies in Fr: Boundaries of the Spherical Single Particle Model

We have measured the hyperfine splitting of the 7P_{1/2} state at the 100 ppm level in Fr isotopes (^{206g,206m,207,209,213,221}Fr) near the closed neutron shell (N=126 in ^{213}Fr). The measurements in five isotopes and a nuclear isomeric state of francium, combined with previous determinations of the 7S_{1/2} splittings, reveal the spatial distribution of the nuclear magnetization, i.e., the Bohr-Weisskopf effect. We compare our results with a simple shell model consisting of unpaired single valence nucleons orbiting a spherical nucleus, and find good agreement over a range of neutron-deficient isotopes (^{207-213}Fr). Also, we find near-constant proton anomalies for several even-N isotopes. This identifies a set of Fr isotopes whose nuclear structure can be understood well enough for the extraction of weak interaction parameters from parity nonconservation studies.