Hemorrhagic infarct of basal ganglia in cardiac arrest. CT and MRI findings. 2 cases

We report the CT and MRI findings in two cases of hemorrhagic infarct of the basal ganglia (BG), following out-of-hospital cardiac arrest (CA). In case 1, Brain-CT realized at day 2 showed bilateral and almost symmetric hemorrhagic infarct of the BG and infarct of the tectum of the mesencephalon. In case 2, MRI realized at day 6 showed hemorrhagic infarct of both lenticular nuclei on T2 GE images. In both cases there was no medical history and the cardiovascular and the coagulation profile were normal. In these cases, the lesions are observed earlier than reported in a few previous radiological cases. Similar lesions have been reported in pathological studies. These lesions seem occur early after CA. Reperfusion is probably responsible for the hemorrhagic transformation. The reason why some patients present either BG or brainstem infarct or both remains unclear. Bilateral and symmetric hemorrhagic infarct of the BG, especially of the Lenticular nuclei, and infarct of the dorsal pons and mesencephalic tegmentum seem to be a characteristic feature of profound and prolonged hypotension or of CA

Akutno otrovanje cijanidima: klinička slika, dijagnoza i liječenje

Cyanide poisoning presents in many forms. Industrial intoxications occur due to extensive use of cyanide compounds as reaction products. Smoke inhalation, a polyintoxication, is most often responsible for domestic cyanide poisonings. Suicidal poisonings are rare. Cyanogenic compounds may produce acute or subacute toxicity. Signs of cyanide poisoning include headache, vertigo, agitation, confusion, coma, convulsions and death. Definitive laboratory confirmation is generally delayed. Elevated plasma lactate, associated with cardiovascular collapse, should suggest cyanide intoxication. Immediate treatment includes 100% oxygen, assisted ventilation, decontamination, correction of acidosis and blood pressure support. Antidotes include oxygen, hydroxocobalamin, di-cobalt EDTA and methaemoglobin-inducers. Hydroxocobalamin is an attractive antidote due to its rapid cyanide binding and its lack of serious side-effects, even in the absence of cyanide intoxication. Sodium thiosulphate acts more slowly than other antidotes and is indicated in subacute cyanogen poisoning and as an adjunct to acute cyanide poisoning. Initial evaluation of antidotal efficacy is based on correction of hypotension and lactic acidosis; the final analysis rests on the degree of permanent central nervous system injury.Otrovanje cijanidima može nastati na različite načine. Profesionalna otrovanja uzrokovana su širokom uporabom cijanidnih spojeva u kemijskoj sintezi. Udisanje dima u požarima najčešći je uzrok otrovanja cijanidima u kućnom okolišu. Otrovanja u svrhu samoubojstava su rijetka. Cijanogeni spojevi mogu uzrokovati akutna ill subakutna otrovanja. Znakovi otrovanja su glavobolja, vrtoglavica, nemir, smetenost, koma, konvulzije i smrt. Konačna laboratorijska potvrda uzroka otrovanja često dolazi sa zakašnjenjem. Povišenje laktata u plazmi praćeno zatajenjem srca i krvotoka upućuje na moguće otrovanje cijanidima. Hitno liječenje uključuje kisik, umjetno disanje, mjere dekontaminacije, suzbijanje acidoze i održavanje krvotoka. Kao antidoti rabe se kisik, hidroksikobalamin, dikobalt-EDTA i lijekovi koji dovode do methemoglobinemije. Hidroksikobalamin je antidot izbora zbog sposobnosti brzog vezanja cijanida, s malo ozbiljnih nuspojava čak i ako otrovanje nije uzrokovano cijanidima. Natrijev tiosulfat djeluje sporije od drugih antidota i indiciran je u subakutnim slučajevima otrovanja te kao pomoćni lijek za akutna otrovanja cijanidima. Početna procjena djelotvornosti antidota temelji se na sposobnosti suzbijanja hipotenzije i laktičke acidoze, dok se konačna ocjena temelji na procjeni stupnja trajnog oštećenja središnjeg živčanog sustava

Performance of an automated multiplex immunofluorescence assay for detection of Chlamydia trachomatis immunoglobulin G.

Chlamydia serology is indicated to investigate etiology of miscarriage, infertility, pelvic inflammatory disease, and ectopic pregnancy. Here, we assessed the reliability of a new automated-multiplex immunofluorescence assay (InoDiag test) to detect specific anti-C. trachomatis immunoglobulin G. Considering immunofluorescence assay (IF) as gold standard, InoDiag tests exhibited similar sensitivities (65.5%) but better specificities (95.1%-98%) than enzyme-linked immunosorbent assays (ELISAs). InoDiag tests demonstrated similar or lower cross-reactivity rates when compared to ELISA or IF

Influence de divers facteurs écologiques sur la bioaccumulation d'éléments métalliques (Cd, Cu, Pb, Zn) chez de jeunes palourdes (Ruditapes philippinarum) au cours du prégrossissement en nourricerie

La bioaccumulation des métaux chez les mollusques peut être une conséquence de la désorption des éléments métalliques fixés sur les particules inertes ou vivantes en suspension dans l'eau qui leur servent de nourriture. Les meilleures expériences réalisées jusqu'ici semblent indiquer que les matières en suspension ont un rôle mineur dans la contamination des mollusques. Mais quelles que soient les précautions prises, les expériences ne simulent jamais parfaitement les phénomènes naturels. Aussi, nous avons choisi de reprendre cette question à l'aide d'une expérience en grand volume où le nombre de paramètres contrôlés est restreint mais où les organismes sont dans des conditions aussi proches que possible de la réalité.Au cours d'un prégrossissement expérimental, les jeunes palourdes reçoivent des quantités variables contrôlées de nourriture phytoplanctonique. La fourniture d'une nourriture plus abondante a pour conséquence d'augmenter les quantités de cuivre et de zinc et au contraire de diminuer celles de plomb contenues dans chaque individu. Elle entraîne également une diminution des concentrations en cadmium et plomb traduisant une « dilution biologique » de ces métaux. L'augmentation de la densité de la population expérimentale a un effet négatif sur les quantités de cuivre et de zinc contenues dans les individus. A âge identique, les individus les plus grands présentent des concentrations plus faibles en cuivre et zinc et plus élevées en cadmium et plomb.L'utilisation des eaux marines souterraines présente deux avantages: une production algale intense à un coût économique négligeable et la possibilité par échange thermique de réchauffer en hiver les eaux marines naturelles et ainsi de maintenir une croissance des mollusques toute l'année. L'emploi des eaux de forage n'entraîne aucun effet néfaste dans les phénomènes de bioaccumulation des métaux, du moins pour ceux étudiés ici : cadmium, cuivre, plomb et zinc.Metal bioaccumulation in bivalves may occur as a consequence of the ingestion of inert or living particles with fixed trace elements. The best experiments like those carried out by BORCHARDT (1983, 1985) concerning Cd in mussels have shown that the role suspended matter plays in the contamination of molluscs is insignificant. But, however reliable the experimental methodologies, laboratory conditions never reproduce perfectly natural phenomena. We planned therefore to restudy the problem by using a largescale experiment where the procedure was characterized by a restricted number of controlled parameters and the organisms as close as possible to the real conditions.During an experimental nursing of young carpet shells, we assessed the influence of various controlled quantifies of phytoplankton and of experimental population density on the transfer of metal from their environment to molluscs.Carpet-shell brood (Ruditapes philippinarum) was distributed in several cylindrical containers the bottom of which consisted in a sieve. Food and seawater were renewed continuously by means of an ascending current (BAUD et BACHER, 1990). Nursing assays were carried out during summer over a period of 74 days. Eight groups of carpet shells were constituted according to food supplies (0, lx, 2x and 4x of Skeletonema costatum grown upon underground seawater plus natural phytoplankton) and population density (25 000 or 50 000 individuals per experimental container). Young molluscs were fed according to a cycle of 3 h-feeding periods and 2 h-periods with no food alternately. The average concentrations of algal cells in mollusc breeding seawater were 17.5, 35 and 70.103 cells/L. This seawater was renewed at a flow rate of 3 m3/h.At the end of the nursing period, molluscs exposed to different experimental conditions were separated by using sieves of different mesh-size (6, 8 and 10 mm). Young carpet shells were purged for 36 h in order to limit the overvaluation of bioaccumulated metal levels due to ingested matter (AMIARD-TRIQUET et al., 1984; KENNEDY, 1986). In each experimental and size-related categories, 90 individuals were sampled and divided into 3 groups of 30 specimens.In these groups, soft tissues were separated from the shells and oven-dried at 80 °C for 48 h. The dry samples were powdered and three aliquot parts of about 100 mg each were digested with 1 ml of concentrated nitric acid (HNO3, Suprapur) at 95 °C for 1 h. Then the trace element analyses were performed in this solution diluted with deionized water by dame (Zn) or by flameless (Cd, Cu, Pb) atomic absorption spectrophotometry using the Zeeman effect (AMIARD et al., 1987).The influence of both food supplies and experimental population density on the dry weight of soil tissues of young carpet shells, their metal concentration and body burdens were examined by means of multi-linear regression analysis.Increasing body burdens of Cu (4) and Zn (5) and decreasing body burden of Pb (3), corresponded to more abundant food supplies. The increase of phytoplankton supplies induced a decrease of Cd (6) and Pb (7) concentrations as a consequence of a « biological dilution » of these metals. Increasing density induced a depletion of Cu (4) and Zn (5) body burdens. Among individuals of the same age, the biggest ones exhibited the lowest concentrations of Cu and Zn (8 and 9) and the highest concentrations of Cd and Pb (6 and 7).Increased food supplies induce a biological dilution of Cd and Pb in young carpet-shells. These results are in agreement with previous data concerning Cd, Cu, Pb and Zn in different species (MACKAY et al., 1975; BOYDEN, 1971; PHELPS et al., 1985; BERTHET, 1986). Thus front a sanitary point of view, the use of ground seawater for algal culture is not a risk since metal concentrations in molluscs are not enhanced

A theoretical and experimental study of the time-dependent radiative properties of a solar bubbling fluidized bed receiver

International audienceIn order to evaluate the potential of solar bubbling fluidized bed receivers compared to other methods for the solar heating of gases at high temperature, a thorough knowledge of the heat transfer of the receiver is necessary. Since the external energy source of the system is radiative and because of high working temperatures, it is particularly important to model the radiative heat transfer to later predict the temperature field in the solar receiver. The aim of this study is to model the radiative flux distribution in a fluidized bed by taking into account the time-dependent absorption and scattering of light in the particulate medium. For this purpose, we propose a model using the Monte Carlo Method as well as a time-dependent field of optical properties that was predicted using a Computational Fluid Dynamics tool implemented with an Eulerian model. A statistical treatment using the k-distribution method was later applied to the time-dependency of the radiative properties of the solar fluidized bed receiver. This method has proven to be useful to reduce computational time while keeping a good accuracy. An experimental set-up was designed to validate the numerical predictions of the particle volume fraction and the penetration of radiation into the fluidized bed. The good agreement of the current model with the experimental data confirms its suitability. (C) 2014 Elsevier Ltd. All rights reserved

Cigarette smoking during pregnancy and adverse perinatal outcomes: a cross-sectional study over 10 years.

It has been shown that active exposure to tobacco is associated with adverse pregnancy outcomes including, but not limited to, intrauterine fetal death, reduced fetal weight, and higher risk of preterm birth. We want to investigate these effects in a high-income country. This cross-sectional study examined 20,843 pregnant women who delivered over 10 years at the Maternity Hospital of the Centre Hospitalier Universitaire Vaudois (CHUV) in Lausanne, Switzerland. The objective was to evaluate a dose-response relationship between daily cigarette use during pregnancy and possible adverse perinatal outcomes. The social and clinical characteristics as well as obstetric and neonatal outcomes were compared between the smoking and the non-smoking groups. Adjusted odds ratios (aOR) and trend analyses (p <sub>trend</sub> ) were calculated. Nineteen thousand five hundred fifty-four pregnant women met the inclusion criteria and 2,714 (13.9%) of them were smokers. Even after adjusting for confounding factors, smoking during pregnancy was associated with preterm birth, birthweight < 2500 g, intrauterine growth restriction, neonatal respiratory and gastrointestinal diseases, transfer to the neonatal intensive care unit, and neonatal intensive care unit admissions > 7 days. Intrauterine death and neonatal infection were associated with heavy smoking (≥ 20 cigarettes/day). Smoking appeared to be a protective factor for pre-eclampsia and umbilical cord arterial pH below 7.1. A significant trend (p <sub>trend</sub> < 0.05) was identified for preterm birth, intrauterine growth restriction, birthweight < 2500 g, umbilical cord arterial pH below 7.1, transfers to our neonatal intensive care unit, and neonatal intensive care unit admissions more than 7 days. Cigarette smoking is associated with several adverse perinatal outcomes of pregnancy with a dose-dependent effect

Clinical review: Aggressive management and extracorporeal support for drug-induced cardiotoxicity

Poisoning may induce failure in multiple organs, leading to death. Supportive treatments and supplementation of failing organs are usually efficient. In contrast, the usefulness of cardiopulmonary bypass in drug-induced shock remains a matter of debate. The majority of deaths results from poisoning with membrane stabilising agents and calcium channel blockers. There is a need for more aggressive treatment in patients not responding to conventional treatments. The development of new antidotes is limited. In contrast, experimental studies support the hypothesis that cardiopulmonary bypass is life-saving. A review of the literature shows that cardiopulmonary bypass of the poisoned heart is feasible. The largest experience has resulted from the use of peripheral cardiopulmonary bypass. However, a literature review does not allow any conclusions regarding the efficiency and indications for this invasive method. Indeed, the majority of reports are single cases, with only one series of seven patients. Appealing results suggest that further studies are needed. Determination of prognostic factors predictive of refractoriness to conventional treatment for cardiotoxic poisonings is mandatory. These prognostic factors are specific for a toxicant or a class of toxicants. Knowledge of them will result in clarification of the indications for cardiopulmonary bypass in poisonings

Microstructural Controls on the Uniaxial Compressive Strength of Porous Rocks Through the Granular to Non‐Granular Transition

Under uniaxial compression, a porous rock fails by coalescence of stress‐induced microcracks. The micromechanical models developed to analyze uniaxial compressive strength data consider a single mechanism for the initiation and propagation of microcracks and a fixed starting microstructure. Because the microstructure of clastic porous rock transitions from granular to non‐granular as porosity decreases during diagenesis, their strength cannot be captured by a single model. Using synthetic samples with independently controlled porosity and initial grain radius we show that high‐porosity granular samples, where microcracks grow at grain‐to‐grain contacts, are best described by a grain‐based model. Low‐porosity non‐granular samples, where microcracks grow from pores, are best described by a pore‐based model. The switch from one model to the other depends on porosity and grain radius. We propose a regime plot that indicates which micromechanical model may be more suitable to predict strength for a given porosity and grain radius