A Single-Lumen Central Venous Catheter for Continuous and Direct Intra-abdominal Pressure Measurement

Background: Abdominal compartment syndrome (ACS) is associated with high morbidity and mortality rates. Therefore, the need for a good diagnostic tool to predict intra-abdominal hypertension (IAH) and progression to ACS is paramount. Bladder pressure (BP) has been used for several years for intra-abdominal pressure (IAP) measurement but has the disadvantage that it is not a continuous measurement. In this study, a single-lumen central venous catheter (CVC) is placed through the abdominal wall into the abdominal cavity to continuously and directly monitor the intra-abdominal pressure (CDIAP). The aim of this study was to evaluate the use of CDIAP to measure BP as a representative of the true IAP. Methods: Both BP and CDIAP were prospectively recorded on a variety of surgical patients admitted to the intensive care unit (ICU) from March 2003 up to December 2004. At the end of the surgical procedure, the CVC was placed through the abdominal wall and connected to a pressure transducer. In addition, the BP was measured through the urine drainage port after clamping the catheter and filling the bladder with 50 ml of 0.9% saline. At least three paired measurements (BP and CDIAP) were performed for at least one day on the ICU in a standardized manner at preset time intervals on each patient. The paired measurements were compared using the Bland-Altman (B-A) method. Data are presented as mean ± standard deviation. Results: Over a period of 22 months (March 2003 until December 2004), 125 paired measurements of both BP and CDIAP were recorded on 25 patients. The mean age was 72.4 ± 6.6 years. Eighteen patients underwent central vascular surgery, and seven patients with peritonitis received laparotomy. The mean CDIAP was 11.4 ± 4.8 (range 2-30) mmHg, and the BP was 12.9 ± 5.3 (range 3-37) mmHg. The mean difference between CDIAP and BP was 1.6 ± 2.7 mmHg. There was an acceptable level of agreement (intraclass correlation 0.82) between IAP measured by BP and IAP measured via CDIAP. Conclusion: Continuous direct intra-abdominal pressure measurement proved that the BP measurement approach of Kron is representative of the IAP. CDIAP measurement is accurate and makes it easier for the nursing staff to be informed of the IAP

Search for direct production of charginos and neutralinos in events with three leptons and missing transverse momentum in √s = 7 TeV pp collisions with the ATLAS detector

A search for the direct production of charginos and neutralinos in final states with three electrons or muons and missing transverse momentum is presented. The analysis is based on 4.7 fb−1 of proton–proton collision data delivered by the Large Hadron Collider and recorded with the ATLAS detector. Observations are consistent with Standard Model expectations in three signal regions that are either depleted or enriched in Z-boson decays. Upper limits at 95% confidence level are set in R-parity conserving phenomenological minimal supersymmetric models and in simplified models, significantly extending previous results

Mental health and physical activity: A COVID-19 viewpoint

COVID-19, which has been declared a pandemic by the World Health Organisation, has become a public health emergency across the globe. It is a highly contagious disease, which elicits high levels of fear amongst the world population and is considered a threat to the world economy. As a response to this pandemic, international governments have devised unconventional measures to guard the health of their citizenry. Among these are the “new normal” country lockdown that mandates working from home, home-schooling of children, and physical/social distancing from friends and family. For the majority, this has resulted in momentary job loss and loneliness, and other psychological illnesses. Hence millions are frightened, depressed and panic easily as a result of the tension due to the uncertainty, which interferes with their job performance, livelihoods, international trade and the world economy. If not mitigated, this is likely to cause physical health deterioration, with severe mental illness being the outcome. To reduce mental health illnesses during and after the COVID-19 pandemic, evidence suggests prioritising regular participation in physical activity and exercise across lifespan. It is also important for medical experts who specialise in the care and management of mental health to recognise physical activity and exercise as a medicine that can ameliorate some mental illnesses and their associated risk factors

Genetic determinism: how not to interpret behavioral genetics

Recently, investigators in behavioral genetics have found loci on the genome (so-called ‘quantitative trait loci’ or QTLs) that are associated with complex mental traits, such as anxiety or novelty seeking. The interpretation of these findings raises interesting theoretical questions. At first sight, the discovery of ‘genes-for-personality’ seems to support genetic determinism and reductionism. Genetic determinism is the view that the phenotype is precoded in or determined by the genotype. However, evidence from developmental biology and neural modeling indicates that development is a result of interactive processes at many levels, not only the genome, so that geneticism must be rejected. Identifying QTLs and perhaps also the causal paths in the tangle of top-down and bottom-up influences between genome, organism and environment is best seen as a simplification. It amounts to considerably less than reduction in the classical sense of replacement via bridge laws or elimination. It is argued that higher (psychological and physiological) levels are functionally characterized and are irreducible to molecular-genetic levels. Therefore, it is to be expected that ideas about inter-level relations may be useful in clarifying the relation between loci on the genome (QTLs), gene products, the nervous system, behavior and personality, and to help identify the contribution of genetic factors in behavioral genetics. © 2000, Sage Publications. All rights reserved

The Biochemical and Cellular Basis for Nutraceutical Strategies to Attenuate Neurodegeneration in Parkinson’s Disease

Future therapeutic intervention that could effectively decelerate the rate of degeneration within the substantia nigra pars compacta (SNc) could add years of mobility and reduce morbidity associated with Parkinson’s disease (PD). Neurodegenerative decline associated with PD is distinguished by extensive damage to SNc dopaminergic (DAergic) neurons and decay of the striatal tract. While genetic mutations or environmental toxins can precipitate pathology, progressive degenerative succession involves a gradual decline in DA neurotransmission/synaptic uptake, impaired oxidative glucose consumption, a rise in striatal lactate and chronic inflammation. Nutraceuticals play a fundamental role in energy metabolism and signaling transduction pathways that control neurotransmission and inflammation. However, the use of nutritional supplements to slow the progression of PD has met with considerable challenge and has thus far proven unsuccessful. This review re-examines precipitating factors and insults involved in PD and how nutraceuticals can affect each of these biological targets. Discussed are disease dynamics (Sections 1 and 2) and natural substances, vitamins and minerals that could impact disease processes (Section 3). Topics include nutritional influences on α-synuclein aggregation, ubiquitin proteasome function, mTOR signaling/lysosomal-autophagy, energy failure, faulty catecholamine trafficking, DA oxidation, synthesis of toxic DA-quinones, o-semiquinones, benzothiazolines, hyperhomocyseinemia, methylation, inflammation and irreversible oxidation of neuromelanin. In summary, it is clear that future research will be required to consider the multi-faceted nature of this disease and re-examine how and why the use of nutritional multi-vitamin-mineral and plant-based combinations could be used to slow the progression of PD, if possible