Optical fiber sensors for monitoring in critical care

Monitoring of key physiological and pharmacological parameters is an important part of a closed loop control system in critical care. Optical fiber sensors provide a versatile platform technology that can be easily incorporated into existing in-dwelling catheters or face masks. With appropriate functional coatings they can be used to monitor a range of relevant parameters and two different examples are presented: (i) respiration monitoring; (ii) drug level monitoring. Respiration monitoring involves monitoring of temperature and humidity in inhaled and exhaled breath. The optical fiber sensor consists of a fiber Bragg grating to measure temperature and a tip coating whose refractive index changes with humidity. The sensor is demonstrated to be able to track breath to breath changes when incorporated into a mask. Drug level monitoring is demonstrated in vitro using a long period grating coated with molecularly imprinted polymer nanoparticles that are sensitive to fentanyl. The sensor has a limit of detection of 50ng/ml.

Transmission line method for the simulation of fiber Bragg gratings

A new method for the analysis and design of fiber Bragg gratings (FBGs) based on the theory of transmission lines has been developed and verified both theoretically and experimentally. The method is an extension of the coupled-mode theory and utilizes the equivalent transmission lines in order to simulate any type of grating, with an easy and direct implementation. The method provides the ability to analyze the optical devices without using full wave approaches, while also facilitating the incorporation of core materials with a complex or non-linear refractive index, non-uniform distributions of the grating's refractive index, and tilted and phase-shifted gratings. The approach also allows the design of the grating for a given reflection spectra. Numerical results of the method's application on a randomly varied inscription of the refractive index of a FBG have also been simulated and discussed. Using this method, the characteristics of an erbium-doped (ED)-FBG have been simulated and the predictions verified experimentally.

DigiScope--unobtrusive collection and annotating of auscultations in real hospital environments

Digital stethoscopes are medical devices that can collect, store and sometimes transmit acoustic auscultation signals in a digital format. These can then be replayed, sent to a colleague for a second opinion, studied in detail after an auscultation, used for training or, as we envision it, can be used as a cheap powerful tool for screening cardiac pathologies. In this work, we present the design, development and deployment of a prototype for collecting and annotating auscultation signals within real hospital environments. Our main objective is not only pave the way for future unobtrusive systems for cardiac pathology screening, but more immediately we aim to create a repository of annotated auscultation signals for biomedical signal processing and machine learning research. The presented prototype revolves around a digital stethoscope that can stream the collected audio signal to a nearby tablet PC. Interaction with this system is based on two models: a data collection model adequate for the uncontrolled hospital environments of both emergency room and primary care, and a data annotation model for offline metadata input. A specific data model was created for the repository. The prototype has been deployed and is currently being tested in two Hospitals, one in Portugal and one in Brazil.

Management of precancerous conditions and lesions in the stomach (MAPS): guideline from the European Society of Gastrointestinal Endoscopy (ESGE), European Helicobacter Study Group (EHSG), European Society of Pathology (ESP), and the Sociedade Portuguesa de Endoscopia Digestiva (SPED)

Atrophic gastritis, intestinal metaplasia, and epithelial dysplasia of the stomach are common and are associated with an increased risk for gastric cancer. In the absence of guidelines, there is wide disparity in the management of patients with these premalignant conditions. The European Society of Gastrointestinal Endoscopy (ESGE), the European Helicobacter Study Group (EHSG), the European Society of Pathology (ESP) and the Sociedade Portuguesa de Endoscopia Digestiva (SPED) have therefore combined efforts to develop evidence-based guidelines on the management of patients with precancerous conditions and lesions of the stomach (termed MAPS). A multidisciplinary group of 63 experts from 24 countries developed these recommendations by means of repeat online voting and a meeting in June 2011 in Porto, Portugal. The recommendations emphasize the increased cancer risk in patients with gastric atrophy and metaplasia, and the need for adequate staging in the case of high grade dysplasia, and they focus on treatment and surveillance indications and methods.

Resonant Raman scattering in ZnO:Mn and ZnO:Mn:Al thin films grown by RF sputtering

Raman spectroscopy results obtained under visible (non-resonant) and UV (resonant) excitation for nanocrystalline ZnO, ZnO:Mn and ZnO:Mn:Al thin films grown by radio frequency magnetron sputtering are presented and compared. The origin of the multiple longitudinal optical (LO) phonon Raman peaks, strongly enhanced under resonance conditions, and the effects of the dopants on them are discussed in the framework of the 'cascade' model. It is suggested that the observed suppression of the higher-order LO phonon lines for ZnO:Mn:Al is caused by the dissociation of excitons in the heavily n-type doped material. On the basis of the cascade model interpretation of the higher-order Raman peaks in the resonant spectra, the LO phonon frequencies for wavevectors away from the Γ point are evaluated and compared to previously published phonon dispersion curves.

Dementia in multiple sclerosis: report of a case with cortical grey matter involvement and frontal-type-like clinical features

Background/introduction

Although multiple sclerosis (MS), a demyelinating disease of unknown aetiology, is primarily a white matter disease, it may also involve the grey matter, a feature not often demonstrated in vivo by means of magnetic resonance imaging (MRI). The involvement of cortical grey matter in MS may account for cognitive dysfunction and behavioural abnormalities.

Objective

The purpose of this report is to present the case of a patient with MS and clinical features mimicking dementia of the frontal type due to clear-cut cortical grey matter involvement in the left frontal lobe.

Case report

A 55-year-old woman with relapsing remitting MS developed a clinical picture characterized by frontal deficits (e.g. attention, verbal fluency, and speed processing), disinhibition, loss of insight, perseveration, abnormal eating behaviour, agitation, insomnia, and depersonalization phenomena. Neuropsychological evaluation also revealed abnormal performance on the Trail Making and the Stroop tests. Besides typical demyelinating lesions and “black holes”, MRI showed a striking pattern of left frontal opercular involvement including cortical thinning, focal knife-edge appearance of the gyri, and marked gliosis in the adjacent white matter.

Discussion

Cognitive deficits in MS are typically subcortical, due to the expected predominance of white matter lesions. Nonetheless, the involvement of grey matter structures may contribute to a different pattern of cognitive dysfunction. For example, hippocampal involvement has been linked to memory impairment. This particular case report additionally illustrates how cortical grey matter involvement in the frontal lobe may lead (not unexpectedly) to a clinical condition mostly characterised by frontal deficits and psychiatric symptoms.

Emamectin benzoate (Affirm). a modern insecticide for the control of lepidoptera larvae on fruits, grapes and vegetables crops

Emamectin benzoate (Affirm) is a novel insecticide with potent efficacy against many specie of lepidoptera which are damaging fruits and leaves of agricultural crops. The active ingredient belongs to the naturally derived chemical group of avermectine, causing paralysis of lepidoptera larvae due to the activation of chloride channel at nerves level. Affirm is acting mainly through ingestion, due to its mode of action and fast activity, it is effective at very low rates and on all instars stages. It has been developed for the use on pomefruits, stonefruits, grapes and a broda range of vegetables crops at a rate range of 1.5 to 3 g ai/100L. The product shows translaminar activity and rapid degradation on leaf surface; therefore the active ingredient breaks down in a very short time to sublethal doses for most beneficials organisms living on the vegetation. The short rentry time, generally 24 hours for beneficials and impollinators, makes Affirm compatible for IPM programme in orchards and greenhouses. Also the residue profile is very favourable, leading to a very low maximum residue level and short preharvest interval in all edible crops.

The safety of thiamethoxam to pollinating bumble bees (Bombus terrestris L.) when applied to tomato plants through drip irrigation

Thiamethoxam, mainly sold under the trademark of Actara, is a neonicotinoid widely used in covered vegetables for the control of aphids and whiteflies. In these crops, and particularly in covered tomatoes, bumble-bees are used for cross-pollination as an alternative to labour intensive manual techniques. In this study, made on tomatoes grown in separated greenhouse plots in Murcia, Southern Spain, thiamethoxam was applied through drip irrigation at a rate of 200 g ai/ha, and as a split application of the same rate, to evaluate the effects on pollinating bumble bees compared to a foliar application of a toxic standard. The results showed that the toxic foliar standard had a clear effect on the pollination of tomato flowers, declining to zero pollination two weeks after application, whereas both the single and split drip irrigation applications of Actara had no effect on pollination when compared to the control plots. The count of dead adults and larvae did not show any differences between the treatments, whereas the measurement of sugar water consumption was shown to correlate well with pollination. The consumption of sugar water declined in the toxic standard plots by 69% with respect to the control, whilst the decline in lower dose drip irrigation application was only 3%. In regard to hive weight, and number of adults and brood after destructive sampling; there were no statistical differences between the treatments but a negative effect of the foliar treatment was observed. Based on these results we can conclude that a split application of Actara applied in drip irrigation to the soil/substrate has no effect on the bumble-bees used in tomatoes for pollination.

Palladium-catalyzed arylation of allylic benzoates using hypervalent siloxane derivatives

Palladium-catalyzed cross-coupling of hypervalent arylsiloxane derivatives proceeded in good to excellent yields with allylic benzoates. Arylation occurred with complete inversion of configuration. The scope and limitations of this reaction, an alternative to the Stille coupling, is summarized.

[Murine typhus in Portugal]

Murine typhus or endemic typhus is a wide spread infectious disease, with a low prevalence in developed countries, but surely underdiagnosed. Its relative benignity, the similarity to other infectious diseases and the discretion of its epidemiologic chain, as well as the usual unexpectedness of its existence, makes its diagnosis more difficult. The clinical presentation and evolution of this case illustrate the necessity of being aware of this nosological entity.

Lignans and isoflavonoids in plasma and prostatic fluid in men: samples from Portugal, Hong Kong, and the United Kingdom

BACKGROUND

Chinese men have lower incidences of prostate cancer compared to men from Europe and North America. Asians consume large quantities of soya, a rich source of isoflavanoids phyto-oestrogens and have high plasma and urinary levels of these compounds. The mammalian lignans, enterolactone and enterodiol, are another group of weak plant oestrogens and are derived from seeds, cereals and grains. Vegetarians have high plasma and urinary concentrations of lignans.

METHODS

The concentrations lignans and isoflavonic phyto-oestrogens were determined by gas chromatography-mass spectrometry (GC-MS) in plasma and prostatic fluid from Portuguese, Chinese and British men consuming their traditional diets.

RESULTS

In prostatic fluid the mean concentrations of enterolactone were 31, 162 and 20.3 ng/ml for Hong Kong, Portugal and Britain respectively. Very high levels of enterolactone (> 600 ng/ml) were observed in the prostatic fluid of some of the men from Portugal. High concentrations of equol (3270 ng/ml) and daidzein (532 ng/ml) were found in a sample of prostatic fluid from Hong Kong. Higher mean levels of daidzein were observed in prostatic fluid from Hong Kong at 70 ng/ml, compared to 4.6 and 11.3 ng/ml in samples from Portugal and Britain respectively. Mean levels of daidzein were higher in the plasma samples from Hong Kong (31.3 ng/ml) compared to those from Portugal (1.3 ng/ml) and Britain (8.2 ng/ml). In general, the mean plasma concentrations of enterolactone from the three centres were similar, at 6.2, 3.9 and 3.9 ng/ml in samples from Hong Kong Portugal and Britain respectively.

CONCLUSIONS

Higher concentrations of the isoflavanoid phyto-oestrogens, daidzein and equol, were found in the plasma and prostatic fluid of men from Hong Kong compared to those from Britain and Portugal. However, the levels of the lignan, enterolactone, were very much higher in prostatic fluid of Portuguese men. Isoflavanoids and lignans have many interesting properties and may, in part, be responsible for lower incidences of prostate cancer in men from Asia and also some Mediterranean countries. The isoflavanoids from soya, which are present in high concentrations in the prostatic fluid of Asian men, may be protective against prostate disease.

Measurement and metabolism of isoflavonoids and lignans in the human male

Asian men, who consume a low fat/high fibre soya-based diet, have very much lower incidence of prostate cancer than men from North America and Europe. The soya bean is a rich source of the isoflavonic phyto-oestrogens, daidzein, genistein and equol, compounds which may be cancer-protective in Asian populations. The lignans, enterolactone and enterodiol, plant oestrogens derived from cereals and vegetables, may act in a similar manner in vegetarian men. We report here on the measurement of isoflavonoids and lignans, by gas chromatography-mass spectrometry, in prostatic fluid of men from Asia and Europe and also on the metabolism of these compounds in Western men following dietary supplementation.

[Hydro-electrolyte changes induced by transurethral prostatic resection]

Transurethral resection prostatectomy (TURP) has been associated with severe hyponatremia due to massive absorption of bladder irrigation fluid (IF). TURP was performed in 41 patients using Sorbitol-Mannitol IF (Group A) and in 6 patients using distilled water (Group B). Six other patients were operated upon using surgical procedures identical in time and type of anesthesia to TURP (Group C). The three groups were studied with the same protocol that included blood collected before (time I), immediately after (time II) the procedure and 1 hour later (time III). Serum sodium decreased significantly in the 3 groups from time I to time II, an average of 3.4 mEq/l with Mannitol-Sorbitol, 2.3 mEq/l with distilled water, and 4.4 mEq/l in group C. Osmolality did not change significantly between the 3 times of collection and Osmolar Gap only increased from time I to II in the Sorbitol-Mannitol group. In conclusion, mild decrements in serum sodium with no clinical relevance are a common post-TURP finding, but should not be greater than in other similar general surgery without bladder irrigation. Hyposmolality did not constitute a problem.