Electrophysiological indices of altered working memory processes in long-term ecstasy users

OBJECTIVE

The aim of this study was to determine the effect of light long-term ecstasy consumption on verbal short-term and working memory and to identify the cognitive processes contributing to task performance.

METHOD

Electroencephalogram was recorded while ecstasy users (N = 11), polydrug users (N = 13), and non-users (N = 13) completed forward and backward serial recognition tasks designed to engage verbal short-term memory and verbal working memory, respectively.

RESULTS

All three groups displayed significantly lower digit-backward span than digit-forward span with ecstasy users displaying the greatest difference. The parietally distributed P3b was significantly smaller in the digits backward task than in the digits forward task in non-ecstasy-using controls. Ecstasy users did not show the reduced P3b component in the backward task that was seen in both non-ecstasy-using control groups.

CONCLUSIONS

Ecstasy users' performance was suppressed more by the concurrent processing demands of the working memory task than that of the non-ecstasy-using controls. Non-ecstasy-using controls showed differential event-related potential wave forms in the short-term and working memory tasks, and this pattern was not seen in the ecstasy users. This is consistent with a reduction in the cognitive resources allocated to processing in working memory in ecstasy users.

Outcome following mesenteric artery revascularisation for chronic mesenteric ischemia

AIM

The purpose of this study was to review the clinical presentation and diagnosis of chronic mesenteric ischaemia (CMI) and to evaluate the early results and late outcome of mesenteric revascularisation.

METHODS

This retrospective study included 15 patients with CMI diagnosed between January 2000 and September 2006. Mesenteric revascularisation was done using either transluminal angioplasty, stenting, endarterectomy or bypass graft. Patients were followed up with Duplex scan and/or computed tomographic angiogram to confirm graft patency.

RESULTS

Sixteen revascularisation procedures were done in 15 patients. Aorto-superior mesenteric artery (SMA) bypass in 9 patients, SMA endarterectomy in 2 patients, transluminal angioplasty in 2 patients, stenting in 2 patients and right common iliac to common hepatic artery bypass in 1 patient with previous failed aorto-SMA graft. There were no perioperative deaths or early procedural complication. Two patients had late graft thrombosis and symptomatic recurrence. One of the three late deaths was due to graft thrombosis and bowel infarction, and the other two died of acute myocardial infarction and disseminated bronchogenic carcinoma respectively.

CONCLUSION

We conclude that mesenteric revascularisation for CMI is successful for most patients with symptomatic relief, low mortality and a good long term graft patency.

A foodborne outbreak of Salmonella Bareilly in the United Kingdom, 2010

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Anonymous living liver donation: donor profiles and outcomes

There are no published series of the assessment process, profiles and outcomes of anonymous, directed or nondirected live liver donation. The outcomes of 29 consecutive potential anonymous liver donors at our center were assessed. We used our standard live liver assessment process, augmented with the following additional acceptance criteria: a logical rationale for donation, a history of social altruism, strong social supports and a willingness to maintain confidentiality of patient information. Seventeen potential donors were rejected and 12 donors were ultimately accepted (six male, six female). All donors were strongly motivated by a desire and sense of responsibility to help others. Four donations were directed toward recipients who undertook media appeals. The donor operations included five left lateral segmentectomies and seven right hepatectomies. The overall donor morbidity was 40% with one patient having a transient Clavien level 3 complication (a pneumothorax). All donors are currently well. None expressed regret about their decision to donate, and all volunteered the opinion that donation had improved their lives. The standard live liver donor assessment process plus our additional requirements appears to provide a robust assessment process for the selection of anonymous live liver donors. Acceptance of anonymous donors enlarges the donor liver pool.

Detection of bacterial contamination in cultures of eucaryotic cells by gas chromatography-mass spectrometry

The use of gas chromatography-mass spectrometry for early detection of bacterial contaminations in cultures of baker's yeast, Penicillium chrysogenum, and an animal cell line was evaluated; muramic acid and characteristic cellular fatty acids were used as analytes. By analyzing branched-chain and cyclopropane-substituted fatty acids as methyl esters, Staphylococcus epidermidis, Bacillus subtilis, Lactobacillus reuteri, Enterobacter cloacae, and Pseudomonas fluorescens were detected in a 500-fold excess (w/w) of baker's yeast; the amounts injected corresponded to 300 ng (dry mass) of the bacteria. Contamination with Bacillus was detected in cultures of Penicillium chrysogenum and animal cells by analyzing muramic acid, both as its alditol acetate derivative, using electron impact ionization, and its trifluoroacetyl methyl glycoside derivative, using negative ion-chemical ionization. The trifluoroacetylated derivative was detected in injected amounts corresponding to 1 x 10(3) bacterial cells in the contaminated animal cell line, whereas amounts corresponding to 1 x 10(5) bacteria were required for detection of the alditol acetate derivative; the amounts in the original samples were 5 x 10(5) and 5 x 10(6), respectively. However, the alditol acetate method exhibited lower chemical interferences than the trifluoroacetyl methyl glycoside procedure. The results show the potential of using gas chromatographic-mass spectrometric analysis of cellular constituents for the detection of bacterial contaminations in eucaryotic cultures as an alternative to conventional microbiological methods.

Neural correlates of successful and partial inhibitions in children: an ERP study

This experiment used event-related potentials (ERPs) to investigate the neural processes underlying the development of response inhibition in a modified version of the go/no-go paradigm [Cragg and Nation [2008] Developmental Science 11(6): 819-827]. N2 and P3 ERP components on correct go trials and partial and successful inhibitions were compared in 7- and 9-year-old children. A larger N2 effect on successful inhibitions was found in 9-year-olds compared to 7-year-olds at fronto-central electrodes. N2 amplitude was positively related to behavioral performance in the 7-year-olds suggesting it may reflect inhibitory processes; however, this relationship was not present in the 9-year-olds. Age differences were also apparent in the go P3, perhaps indicating differences in stimulus processing. The no-go P3 component was larger on successful than partial inhibitions. In contrast, there was no difference in N2 amplitude between partial and successful inhibitions. A significant difference was found in N2 latency however. This suggests that inhibitory processes are similar in both cases but initiated earlier on successful inhibitions. N2 latency was also shorter in 9-year-olds than 7-year-olds supporting an increase in the efficiency of response inhibition with age.

Avian influenza--a review for doctors in travel medicine

First identified in humans in Hong Kong, influenza A/H5N1, known commonly as avian influenza, has caused human disease in 15 countries around the world. Although the current number of confirmed patients is tiny compared to seasonal and the recently emerged H1N1 'swine' influenza, H5N1 remains a candidate for the next highly pathogenic influenza pandemic. Currently, H5N1 has very limited ability to spread from person-to-person but this may change because of mutation or reassortment with other influenza viruses leading to an influenza pandemic with high mortality. If this occurs travellers are likely to be affected and travel medicine doctors will need to consider avian influenza in returning febrile travellers. The early clinical features may be dismissed easily as 'the flu' resulting in delayed treatment. Treatment options are limited. Oral oseltamivir alone has been the most commonly used drug but mortality remains substantial, up to 80% in Indonesia. Intravenous peramivir has been filed for registration and IV zanamivir is being developed. This review will focus on the epidemiological and clinical features of influenza A/H5N1 avian influenza and will highlight aspects relevant to travel medicine doctors.

An Interesting Case of Recurrent Small Bowel Obstruction

Sclerosing mesenteritis is associated with a spectrum of diseases which include mesenteric lipodystrophy and mesenteric panniculitis. This inflammatory and fibrosing disorder can affect the small and large bowel wall and mesenteric vessels by exerting a mass effect. The following case highlights the difficulties with diagnosing and managing this unusual disease. A 64-year-old man presented with acute central abdominal pain, radiating to his back, and profuse vomiting. He was diagnosed clinically with small bowel obstruction. He had had an episode of small bowel obstruction 6 years earlier. At this time, he underwent an exploratory laparotomy, and a mass was identified in the small bowel mesentery. The features were thought to be in keeping with sclerosing mesenteritis. He had a dramatically favourable response to the initiation of prednisolone. He continued to be well and asymptomatic for a further 5 years on long-term maintenance low-dose steroids and 6-mercaptopurine. He re-presented in 2009 (six years after initial presentation) with very severe acute abdominal pain and vomiting. He had no recent change in weight or appetite, and had not had time off work. He underwent a second laparotomy and the tissue diagnosis was of metastatic carcinoid tumour involving the small bowel mesentery. This is the first case to our knowledge where sclerosing mesenteritis has been confirmed histologically on biopsy and then subsequently diagnosed with histologically proven carcinoid tumour. For this particular reason it must be always remembered that sclerosing mesenteritis is a 'pathological' and not a radiological diagnosis and that a large proportion of cases are associated with neoplasia.

The cognitive competence of speakers with acquired dysarthria: Judgements by doctors and speech and language therapists

BACKGROUND

Studies have shown that listeners make negative attributions towards people with communication impairments. This appears to be the case for health care professionals as well as non-professional listeners.

AIMS

This study extends this line of research to speakers with acquired dysarthria. These clients often complain that listeners treat them differently after the onset of their speech impairment. The study examines judgements of the cognitive status of speakers with acquired dysarthria made by health care professionals.

METHODS AND PROCEDURES

Doctors, speech and language therapists and speech and language therapy students viewed videos of speakers with acquired dysarthria and of controls matched for age and gender who had acquired neurological deficits that did not affect their speech. Listeners judged whether speakers could carry out a number of everyday tasks. All the tasks were known to be within the speakers' competence.

OUTCOMES AND RESULTS

Doctors were significantly less confident of the competence of speakers with dysarthria than of the controls. No difference was found for speech and language therapists or speech and language therapy students.

CONCLUSIONS

Although caution is required in generalizing these results to other speakers, the results lend some support to the complaints of clients with acquired dysarthria that their speech leads others, in this case doctors, to misjudge their cognitive competence.

High throughput interaction data reveals degree conservation of hub proteins

Research in model organisms relies on unspoken assumptions about the conservation of protein-protein interactions across species, yet several analyses suggest such conservation is limited. Fortunately, for many purposes the crucial issue is not global conservation of interactions, but preferential conservation of functionally important ones. An observed bias towards essentiality in highly-connected proteins implies the functional importance of such "hubs". We therefore define the notion of degree-conservation and demonstrate that hubs are preferentially degree-conserved. We show that a protein is more likely to be a hub if it has a high-degree ortholog, and that once a protein becomes a hub, it tends to remain so. We also identify a positive correlation between the average degree of a protein and the conservation of its interaction partners, and we find that the conservation of individual hub interactions is surprisingly high. Our work has important implications for prediction of protein function, computational inference of PPIs, and interpretation of data from model organisms.

Quantification of circulating cell-free plasma DNA and endothelial gene RNA in patients with burns and relation to acute thermal injury

BACKGROUND

Major burn represents a multi-system insult to the human body. Despite improvements in mortality and morbidity, reliable predictors of outcome are lacking. Raised levels of cell-free nucleic acids have been detected in various pathological processes including burns. We quantified circulating nucleic acids as potential objective measures of burn severity with predictive and prognostic value.

METHODS

Expression of endothelial specific cell-free mRNA and cell-free DNA were measured in plasma of 19 burn patients at days 1-3 and week 10 following acute thermal injury and in 19 healthy controls by real-time quantitative PCR.

RESULTS

Expression of endothelial specific mRNA was higher in burn patients compared to controls (p<0.001). DNA levels were significantly higher in the burn population in the first 48 h following injury. Plasma RNA and DNA levels related to %TBSA burn in the first 24h and to the levels of circulating endothelial progenitor cells.

CONCLUSIONS

We show that plasma levels of endothelial specific mRNA and DNA are elevated acutely following burns, and relate to severity in terms of %TBSA burnt.

Mobilization of endothelial progenitor cells into the circulation in burned patients

BACKGROUND

Bone marrow-derived endothelial progenitor cells (EPCs) have been detected in the peripheral blood of patients following thermal injury. EPCs migrate to sites of active neovascularization in response to mediators released after trauma, contributing to wound healing. The aim was to characterize levels and kinetics of EPCs in burned patients, then relate these to key mobilizing factors, vascular endothelial growth factor (VEGF) and the chemokine (C-X-C motif) ligand 12 (CXCL 12), and compare them with those in healthy subjects.

METHODS

The study included 19 adult patients with superficial or full-thickness burns and 50 blood donor volunteer controls. EPCs, identified by cell surface markers CD45(dim/-), CD133+, CD144+ and VEGF receptor 2, were quantified by four-colour flow cytometry. Plasma VEGF and CXCL12 were measured using enzyme-linked immunosorbent assay.

RESULTS

Burned patients showed a rapid rise in EPC levels within 24 h, a ninefold increase compared with controls, returning to basal levels by 72 h. Body surface area burned correlated strongly with the degree of mobilization. EPC levels correlated significantly with rises in plasma VEGF and CXCL12.

CONCLUSION

Thermal injury induced a rapid rise in EPCs that was proportional to the extent of the burn and significantly correlated with levels of angiogenic cytokines. Such cytokines may be used to stimulate EPCs as a future therapeutic target in burned patients.

Benign surgical emphysema of the hand and upper limb: gas is not always gangrene--a report of two cases

Subcutaneous emphysema of the hand can result from benign causes. Differentiating this from emphysema caused by gas-forming organisms is essential in the acute stages of presentation as the management differs considerably. We present two cases of benign surgical emphysema and highlight the importance of distinguishing between this and gas gangrene. A considered history and the absence of systemic features associated with benign causes of subcutaneous air will prevent unnecessary surgical exploration.

The Evolution of HIV illness representation among marginally housed persons

Many HIV-infected marginally housed individuals have difficulty engaging in health care. To investigate HIV health-related behaviour, 14 in-depth interviews with marginally housed HIV-infected individuals were conducted and analysed utilizing standard qualitative methodologies. The analysis was based on the Illness Representation Model, which describes five conceptual dimensions of illness: identification; cause; timeline; management; and consequences. A theoretical model of illness representation at two distinct time points emerged and included the two categories: 'didn't suspect and didn't believe it' and 'knew but needed proof'. In this study illness representation categories were found to evolve and change over time, and were associated with engagement in HIV care. This study may help guide programmes that focus on enhancing health-promoting behaviour and improving engagement in health care among marginally housed individuals.

FOXP3 gene expression in a tuberculosis case contact study

Regulatory T lymphocytes (T(regs)) that express FOXP3 are involved in the beneficial attenuation of immunopathology, but are also implicated in down-regulation of protective responses to infection. Their role in tuberculosis (TB) is unknown. We classified 1272 healthy TB contacts according to their tuberculin skin test (TST) and interferon (IFN)-gamma enzyme-linked immunospot (ELISPOT) results and 128 TB cases, and studied the expression of FOXP3 and interleukin (IL)-10 in blood samples. Compared to the uninfected contact group (TST(-), ELISPOT(-)), we observed higher levels of FOXP3 mRNA in blood from TB patients (< 0.001), but IL-10 expression was slightly lower (P = 0.04). In contrast, FOXP3 expression levels were significantly lower (P = 0.001) in the recently infected contacts (TST(+), ELISPOT(+)) but there was no difference for IL-10 (P = 0.74). We hypothesize that during early/subclinical TB, most of which will become latent, FOXP3(+) T(regs) may be sequestered in the lungs, but when TB becomes progressive, FOXP3 reappears at increased levels in the periphery. While these findings do not reveal the role, beneficial or harmful, of T(regs) in TB, they emphasize the probable importance of these cells.