Mitral valve infective endocarditis following device occlusion of a coronary artery fistula

A three year old girl, with a right coronary artery fistula and signs of a hyperdynamic circulation, underwent uncomplicated closure of the fistula using an occluding device introduced via the femoral arterial route and covered with appropriate antibiotics. Two months later she presented with a persistent fever, signs of infective endocarditis (IE) and embolic phenomena in the left lower limb. Mitral valve endocarditis was confirmed immediately and treated effectively. However, initial ultrasound and doppler did not show the femoral artery thrombo-occlusion that was only confirmed on magnetic resonance angiography (MRA) one month later. This case highlights the usefulness of MRA in diagnosing suspected vessel occlusion in young children, and is in keeping with the latest NICE guidelines that suggest that prophylactic antibiotics do not always prevent IE. Parent and patient education on ‘what to look out for’, combined with careful clinical vigilance is paramount in the early detection of IE with a consequent reduction in morbidity and mortality.peer-reviewe

Retroperitoneal fibrosis: a case of a patient (63y/o) treated with low-dose methotrexate (MTX) and 6-methylprednisolone (6-MP)

Retroperitoneal fibrosis (RPF), is a rare fibroinflammatory disease. The pathogenesis of RPF is still unclear and numerous theories have been reported such as environmental factors, immunologic process, genetic component, local inflammation and advanced atherosclerosis. RPF is characterized by the presence of a particular retroperitoneal fibrotic tissue which is white, woody and involving retroperitoneal structures such as the great vessels, ureters and psoas muscle. The main complication of RPF is the obstruction of local structures such as the ureters due to the fibrosis and the treatment of this aspect represents the main challenge for this pathology. RPF medical treatment consists of corticosteroids or/and immunosuppressive therapy. We report a case of a patient (63y/o) affected by idiopathic RPF treated with low-dose methotrexate (MTX) and 6-methylprednisolone (6-MP) for two years, describing and confirming the effectiveness and safety of a long-term low-dose MTX and 6-MP treatment

Hydrozoa, fjord Comau, Chile.

The shallow-water hydrozoan fauna of fjordComau is surveyed. A total of thirty three specieswere recorded. They have been assigned to eightfamilies of Athecata, eight families of Thecata,two families of Narcomedusae and one family ofTrachymedusae. Their ecology is brieflydiscussed

Gas Purity effect on GEM Performance in He and Ne at Low Temperatures

The performance of Gas Electron Multipliers (GEMs) in gaseous He, Ne, He+H2 and Ne+H2 was studied at temperatures in the range of 3-293 K. This paper reports on previously published measurements and additional studies on the effects of the purity of the gases in which the GEM performance is evaluated. In He, at temperatures between 77 and 293 K, triple-GEM structures operate at rather high gains, exceeding 1000. There is an indication that this high gain is achieved through the Penning effect as a result of impurities in the gas. At lower temperatures the gain-voltage characteristics are significantly modified probably due to the freeze-out of these impurities. Double-GEM and single-GEM structures can operate down to 3 K at gains reaching only several tens at a gas density of about 0.5 g/l; at higher densities the maximum gain drops further. In Ne, the maximum gain also drops at cryogenic temperatures. The gain drop in Ne at low temperatures can be re-established in Penning mixtures of Ne+H2: very high gains, exceeding 104, have been obtained in these mixtures at 30-77 K, at a density of 9.2 g/l which corresponds to saturated Ne vapor density at 27 K. The addition of small amounts of H2 in He also re-establishes large GEM gains above 30 K but no gain was observed in He+H2 at 4 K and a density of 1.7 g/l (corresponding to roughly one-tenth of the saturated vapor density). These studies are, in part, being pursued in the development of two-phase He and Ne detectors for solar neutrino detection.Comment: 4 pages, 7 figure

A roadmap to integrate astrocytes into Systems Neuroscience.

Systems neuroscience is still mainly a neuronal field, despite the plethora of evidence supporting the fact that astrocytes modulate local neural circuits, networks, and complex behaviors. In this article, we sought to identify which types of studies are necessary to establish whether astrocytes, beyond their well-documented homeostatic and metabolic functions, perform computations implementing mathematical algorithms that sub-serve coding and higher-brain functions. First, we reviewed Systems-like studies that include astrocytes in order to identify computational operations that these cells may perform, using Ca2+ transients as their encoding language. The analysis suggests that astrocytes may carry out canonical computations in a time scale of subseconds to seconds in sensory processing, neuromodulation, brain state, memory formation, fear, and complex homeostatic reflexes. Next, we propose a list of actions to gain insight into the outstanding question of which variables are encoded by such computations. The application of statistical analyses based on machine learning, such as dimensionality reduction and decoding in the context of complex behaviors, combined with connectomics of astrocyte-neuronal circuits, is, in our view, fundamental undertakings. We also discuss technical and analytical approaches to study neuronal and astrocytic populations simultaneously, and the inclusion of astrocytes in advanced modeling of neural circuits, as well as in theories currently under exploration such as predictive coding and energy-efficient coding. Clarifying the relationship between astrocytic Ca2+ and brain coding may represent a leap forward toward novel approaches in the study of astrocytes in health and disease

Transcatheter device closure of atrial septal defect and patent foramen ovale in Malta

Significant atrial septal defects (ASD) are closed, surgically or through a transcatheter device, in order to avoid pulmonary hypertension in late life. A patent foramen ovale (PFO) may need to be closed because of transient shunt reversal resulting in transient ischaemic events or stroke. We report the Maltese experience to date in transcatheter closure of these defects. A total of 46 ASDs and 51 PFOs have been successfully closed at our unit (total 97), with very low complication rates, rates that compare very favourably with results from larger international centres.peer-reviewe

A comparison of Colletotrichum species associated with berry diseases of Coffea arabica L.

Forty isolates of Colletotrichum species associated with coffee berry anthracnose in Papua New Guinea were characterised and identified on the basis of cultural, morphological and molecular characteristics. Of these, 29 isolates were identified as C. gloeosporioides, while the 11 remaining were identified as C. acutatum. None of the isolates had characteristics common to C. kahawae

Top Quark Physics at the Tevatron

We review the field of top-quark physics with an emphasis on experimental techniques. The role of the top quark in the Standard Model of particle physics is summarized and the basic phenomenology of top-quark production and decay is introduced. We discuss how contributions from physics beyond the Standard Model could affect top-quark properties or event samples. The many measurements made at the Fermilab Tevatron, which test the Standard Model predictions or probe for direct evidence of new physics using the top-quark event samples, are reviewed here.Comment: 50 pages, 17 figures, 2 tables; version accepted by Review of Modern Physic