Spontaneous coronary artery dissection in a young man - Case report

A 31 year old man with a 17-year-history of drug abuse (heroine and cannabis) was admitted with recurrent chest pain over a period of about three weeks. Chest discomfort severely worsened during the 5 hours before hospital admission. Electrocardiography revealed poor R-wave progression and non specific repolarization abnormalities. Echocardiography showed extensive left ventricular anterior and apical wall motion abnormalities and a ventricular thrombus located at the apex of the left ventricle was present. Subsequently, a diagnosis of acute coronary syndrome was made. Coronary angiography revealed spontaneous coronary artery dissection of the left anterior descending (LAD) artery with Thrombolysis In Myocardial Infarction (TIMI) flow 2 to 3. We managed the patient conservatively. The clinical course was uneventful and repeated angiography on day 4 demonstrated spontaneous healing of large parts of the dissection with TIMI 3 flow in the LAD

Pollination and biological control research: are we neglecting two billion smallholders

Food insecurity is a major world problem, with ca. 870 million people in the world being chronically undernourished. Most of these people live in tropical, developing regions and rely on smallholder farming for food security. Solving the problem of food insecurity is thought to depend, in part, on managing ecosystem services, such as the pollination of crops and the biological control of crop pests, to enhance or maintain food production. Our knowledge regarding regulating ecosystem services in smallholder-farmed (or dualistic) landscapes is limited and whilst pollination has been the focus of considerable research, the provision of natural enemy services, important for every crop worldwide, has been relatively neglected. In order to assess whether ecosystem-service research adequately represents smallholder-farmed landscapes, whilst also considering climatic region and national economic status, we examined the constituent studies of recent quantitative reviews relevant to biological control and pollination. No regulating ecosystem service meta-analysis, to our knowledge, has focussed on smallholder agriculture despite its importance to billions of peoples’ local food security. We found that whilst smallholdings contributed 16% of global farmland area and 83% of the global agricultural population (estimated using FAO’s World Census of Agriculture 2000) only 22 of 190 studies (12%), overall, came from smallholder-farmed landscapes. These smallholder studies mostly concerned coffee production (16 studies). Individual reviews of biological control were significantly and strongly biased towards data from large-scale farming in temperate regions. In contrast pollination reviews included more smallholder studies and were more balanced for climate regions. The high diversity of smallholder-farmed landscapes implies that more research will be needed to understand them compared to large-scale landscapes but we found far more research from the latter. We highlight that these skews in research effort have implications for sustainable intensification and the food security of billions in the developing world. In particular we urge for balance in future ecosystem-services research and synthesis by greater consideration of a diverse range of smallholder-farmed landscapes in Africa and continental Asia

Surfing the spectrum - what is on the horizon?

Diagnostic imaging techniques have evolved with technological advancements - but how far? The objective of this article was to explore the electromagnetic spectrum to find imaging techniques which may deliver diagnostic information of equal, or improved, standing to conventional radiographs and to explore any developments within radiography which may yield improved diagnostic data. A comprehensive literature search was performed using Medline, Web of Knowledge, Science Direct and PubMed Databases. Boolean Operators were used and key-terms included (not exclusively): terahertz, X-ray, ultraviolet, visible, infra-red, magnetic resonance, dental, diagnostic, caries and periodontal. Radiographic techniques are primarily used for diagnostic imaging in dentistry, and continued developments in X-ray imaging include: phase contrast, darkfield and spectral imaging. Other modalities have potential application, for example, terahertz, laser doppler and optical techniques, but require further development. In particular, infra-red imaging has regenerated interest with caries detection in vitro, due to improved quality and accessibility of cameras. Non-ionising imaging techniques, for example, infra-red, are becoming more commensurate with traditional radiographic techniques for caries detection. Nevertheless, X-rays continue to be the leading diagnostic image for dentists, with improved diagnostic potential for lower radiation dose becoming a reality